Retroperitoneoscopic radical nephrectomy by the posterior lumber approach for renal-cell carcinoma associated with chronic renal failure.
OBJECTIVE
To evaluate the efficacy and invasiveness of retroperitoneoscopic radical nephrectomy for renal-cell carcinoma (RCC) in patients with chronic renal failure (CRF), a group known to have relatively high surgical risk.


METHODS
Between May 1996 and September 1999, six CRF patients maintained on hemodialysis underwent retroperitoneoscopic radical nephrectomy for clinically localized RCC by the posterior lumber approach. The excised kidneys were evacuated via a posterior skin incision (5 cm) between two port sites; the muscle layers were not incised.


RESULTS
The procedure was completed in all patients with no major complications. The mean operative time was 162 (range 135-210) minutes, and the estimated blood loss was 58 (15-100) mL; none of the patients required a blood transfusion. Regular hemodialysis was restarted on postoperative day 2 or 3.


CONCLUSIONS
This procedure seems to be minimally invasive and suitable for the treatment of small RCC in atrophic kidneys, especially in patients with CRF.
Iwamura
M
M
Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. miwamura@med.kitasato-u.ac.jp
Koh
H
H
Soh
S
S
Irie
A
A
Egawa
S
S
Murai
M
M
Baba
S
S
D001284:Atrophy; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000473:pathology / Q000628:therapy; D007680:Kidney Neoplasms / Q000150:complications / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009392:Nephrectomy / Q000379:methods*; D006435:Renal Dialysis; D012187:Retroperitoneal Space / Q000601:surgery; D016896:Treatment Outcome