OBJECTIVES: Evaluation of clamp-off laser-assisted laparoscopic partial nephrectomy technique (LLPN) compared to the clamp-off laparoscopic (LPN) and open (OPN) techniques. PATIENTS AND METHODS: Between September 2008 and July 2011, 36 patients suffering from small peripheral renal tumours (RT) underwent LLPN (n = 12), LPN (n = 12) and OPN (n = 12) in a prospective single-centre study. RT were excised with laser, Sonosurg or monopolar scissors during LLPN, LPN and OPN, respectively. Blood vessels are identified and sutured before opening them; alternatively, laser energy was used to coagulate them (LLPN). Early and late postoperative complications were assessed. Follow-up was done according to EAU-guidelines. RESULTS: Mean age was 64.9 years. Mean operative time was 135.8 min (100-180) versus 144.2 (85-255) versus 113.6 (50-170) for LLPN versus LPN versus OPN, respectively. Median estimated blood loss (EBL) was 170.8 ml (50-600) versus 245.2 (50-700) versus 425.8 (100-900) for LLPN versus LPN versus OPN, respectively. Tumours (19 right and 17 left) were located in upper (11), midparenchyma (13) and lower pole (12). Mean tumour size was 2.7 cm (1.2-5.5). There were no reported perioperative complications/conversions. There were no positive margins. Histological evaluations were not compromised in any LLPN-case. Compared to LPN, LLPN offered significant lower EBL, shorter operative time, otherwise, comparable results. Follow-up was uneventful without tumour recurrences. CONCLUSION: Current prospective comparative study shows that LLPN is a reproducible efficient alternative to LPN/OPN. Besides the absence of renal ischaemia, LLPN offered lower EBL, good haemostasis and minimal parenchyma damage. Surgical and oncological outcomes are comparable to LPN and OPN.
OBJECTIVES: Evaluation of clamp-off laser-assisted laparoscopic partial nephrectomy technique (LLPN) compared to the clamp-off laparoscopic (LPN) and open (OPN) techniques. PATIENTS AND METHODS: Between September 2008 and July 2011, 36 patients suffering from small peripheral renal tumours (RT) underwent LLPN (n = 12), LPN (n = 12) and OPN (n = 12) in a prospective single-centre study. RT were excised with laser, Sonosurg or monopolar scissors during LLPN, LPN and OPN, respectively. Blood vessels are identified and sutured before opening them; alternatively, laser energy was used to coagulate them (LLPN). Early and late postoperative complications were assessed. Follow-up was done according to EAU-guidelines. RESULTS: Mean age was 64.9 years. Mean operative time was 135.8 min (100-180) versus 144.2 (85-255) versus 113.6 (50-170) for LLPN versus LPN versus OPN, respectively. Median estimated blood loss (EBL) was 170.8 ml (50-600) versus 245.2 (50-700) versus 425.8 (100-900) for LLPN versus LPN versus OPN, respectively. Tumours (19 right and 17 left) were located in upper (11), midparenchyma (13) and lower pole (12). Mean tumour size was 2.7 cm (1.2-5.5). There were no reported perioperative complications/conversions. There were no positive margins. Histological evaluations were not compromised in any LLPN-case. Compared to LPN, LLPN offered significant lower EBL, shorter operative time, otherwise, comparable results. Follow-up was uneventful without tumour recurrences. CONCLUSION: Current prospective comparative study shows that LLPN is a reproducible efficient alternative to LPN/OPN. Besides the absence of renal ischaemia, LLPN offered lower EBL, good haemostasis and minimal parenchyma damage. Surgical and oncological outcomes are comparable to LPN and OPN.
Authors: Stephen B Williams; Ravi Kacker; Mehrdad Alemozaffar; Ignacio San Francisco; Jodi Mechaber; Andrew A Wagner Journal: World J Urol Date: 2011-01-29 Impact factor: 4.226
Authors: Aurélien Descazeaud; Gregoire Robert; Abdel Rahmene Azzousi; Charles Ballereau; Bertrand Lukacs; Olivier Haillot; Olivier Dumonceau; Marian Devonec; Marc Fourmarier; Christian Saussine; Alexandre de la Taille Journal: BJU Int Date: 2009-12-22 Impact factor: 5.588
Authors: Anup P Ramani; Mihir M Desai; Andrew P Steinberg; Christopher S Ng; Sidney C Abreu; Jihad H Kaouk; Antonio Finelli; Andrew C Novick; Inderbir S Gill Journal: J Urol Date: 2005-01 Impact factor: 7.450
Authors: Michael Seitz; Ronald Sroka; Christian Gratzke; Boris Schlenker; Verena Steinbrecher; Wael Khoder; Derya Tilki; Alexander Bachmann; Christian Stief; Oliver Reich Journal: Eur Urol Date: 2007-06-26 Impact factor: 20.096
Authors: Francesco Greco; Riccardo Autorino; Vincenzo Altieri; Steven Campbell; Vincenzo Ficarra; Inderbir Gill; Alexander Kutikov; Alex Mottrie; Vincenzo Mirone; Hendrik van Poppel Journal: Eur Urol Date: 2018-10-13 Impact factor: 24.267
Authors: Martin Drerup; Ahmed Magdy; Martina Hager; Daniela Colleselli; Thomas Kunit; Lukas Lusuardi; Günter Janetschek; Michael Mitterberger Journal: BMC Urol Date: 2018-11-09 Impact factor: 2.264