title: Retroperitoneoscopic partial nephrectomy using microwave coagulation for small renal tumors.
abstract: OBJECTIVE
  The outcome of laparoscopic partial nephrectomy using a microwave tissue coagulator for treatment of small renal tumors was studied.
  
  
  METHODS
  From June 1999 to May 2001, eight patients with small renal tumors of less than 5.0cm in diameter (1.0-5.0cm, T1N0M0) underwent retroperitoneoscopic partial nephrectomy. To control bleeding during the partial nephrectomy, the renal parenchyma around the tumor was coagulated using a microwave tissue coagulator with a needle of 1.5cm length. The tumor was circumscribed within the coagulated area with 8-13 punctures of the coagulation needle, and partial nephrectomy was performed using scissors and bipolar forceps.
  
  
  RESULTS
  All eight patients successfully underwent the procedure retroperitoneoscopically. The average operative time was 295 minutes and the average blood loss was 129ml. Three patients showed urine leakage from the renal calyces, which was controlled by suturing retroperitoneoscopically. In two patients, the surgical margin was revealed to be positive for renal cell carcinoma by frozen section pathology and additional resection was performed in these individuals. The patients were discharged from the hospital with almost full convalescence on day 10 on average. Within the mean follow-up period of 10.4 months, no recurrence was found when examined with computer tomography (CT) using contrast media. As a complication, one patient experienced a decrease in function of the operated kidney caused by unknown reason.
  
  
  CONCLUSIONS
  Retroperitoneal partial nephrectomy using a microwave tissue coagulator is useful for treatment of small renal tumors located at the peripheral area of the kidney. Bleeding from the renal parenchymal incision site is well controlled without occlusion of the renal artery with additional use of a bipolar coagulator, when necessary. Further experience and long-term follow-up are mandatory however, to establish the usefulness of this technique.
authors.affiliation: Department of Urology, Kansai Medical University, 10-15 Fumizono, Moriguchi, Osaka 570-8507, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Murota
authors.forename: Mutsushi
authors.initials: M
authors.lastname: Kawakita
authors.forename: Naoki
authors.initials: N
authors.lastname: Oguchi
authors.forename: Osamu
authors.initials: O
authors.lastname: Shimada
authors.forename: Shozo
authors.initials: S
authors.lastname: Danno
authors.forename: Ichiro
authors.initials: I
authors.lastname: Fujita
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D000328:Adult; D000368:Aged; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D016896:Treatment Outcome