title: Results of retroperitoneal laparoscopic radical nephrectomy.
abstract: OBJECTIVE
  To analyze the retroperitoneal approach to laparoscopic radical nephrectomy in terms of feasibility, safety, morbidity, and cancer control.
  
  
  METHODS
  We reviewed the records of 50 consecutive patients with renal cancer underwent radical nephrectomy via the retroperitoneal laparoscopic approach from 1995 through 1999.
  
  
  RESULTS
  The mean operative time was 139 minutes (range 60-330 minutes) with a mean of 149.78-mL operative blood loss (0-1500 mL). The mean renal size was 100 mm (70-150 mm) with a mean tumor size of 38.6 mm (20-90 mm). The postoperative hospital was 6 days (2-13 days). Three open conversions were necessary: one for laparoscopically uncontrolled bleeding and two because obesity interfered with surgery. We noted two major complication and two minor complications. Two disease progression have been noted to date. One patient with a pT3 grade 2 renal-cell carcinoma had a local recurrence with liver metastasis 9 months after the procedure and died 19.7 months after radical nephrectomy. Another patient with a pT3aN+M+ cancer died 23.1 months after the procedure.
  
  
  CONCLUSIONS
  Retroperitoneal laparoscopic nephrectomy for kidney cancer requires further assessment. It seems to have several advantages over open radical nephrectomy and to be effective and safe for small (<50-mm) renal tumors.
authors.affiliation: Service d'Urologie, Hĵpital Henri Mondor, Créteil, France.
authors.forename: A
authors.initials: A
authors.lastname: Cicco
authors.forename: L
authors.initials: L
authors.lastname: Salomon
authors.forename: A
authors.initials: A
authors.lastname: Hoznek
authors.forename: F
authors.initials: F
authors.lastname: Saint
authors.forename: W
authors.initials: W
authors.lastname: Alame
authors.forename: D
authors.initials: D
authors.lastname: Gasman
authors.forename: P
authors.initials: P
authors.lastname: Antiphon
authors.forename: D K
authors.initials: DK
authors.lastname: Chopin
authors.forename: C C
authors.initials: CC
authors.lastname: Abbou
mesh_terms: D002292:Carcinoma, Renal Cell / Q000556:secondary / Q000601:surgery; D018450:Disease Progression; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000556:secondary; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome