title: Endoscopic minilaparotomy partial nephrectomy for solitary renal cell carcinoma smaller than 4 cm.
abstract: BACKGROUND
  For small, incidentally discovered renal cell carcinoma, partial nephrectomy is becoming more widely accepted as an alternative to radical nephrectomy and the need for minimally invasive approach is increasing.
  
  
  METHODS
  We carried out endoscopic minilaparotomy partial nephrectomy in seven cases of solitary renal cell carcinoma smaller than 4 cm. Five of them were without renal pedicle clamping. All procedures were done through single skin incision (5-8 cm) using a 30 degrees telescope. Hemostasis was achieved with a harmonic scalpel, a microwave tissue coagulator, an argon beam coagulator and autologous fibrin glue.
  
  
  RESULTS
  There were no perioperative complications. All patients had negative surgical margins. The operating time was 157-275 min (average 209 min). The blood loss was 20-1200 ml (average 525 ml). Postoperatively, renal function as assessed by serum creatinine was within normal limits. Neither local recurrences nor metastases were observed during a follow-up of 6-15 months. The postoperative course was markedly improved over that expected from standard open surgery.
  
  
  CONCLUSIONS
  With minimal morbidity and complications, endoscopic minilaparotomy partial nephrectomy is feasible for small renal cell carcinoma.
authors.affiliation: Department of Urology and Reproductive Medicine, Graduate School Tokyo Medical and Dental University, Tokyo, Japan. kageyys.uro@tmd.ac.jp
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kageyama
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kihara
authors.forename: Minato
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Sakai
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Koga
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Saito
authors.forename: Masataka
authors.initials: M
authors.lastname: Yano
authors.forename: Gaku
authors.initials: G
authors.lastname: Arai
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Hyochi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Masuda
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujii
authors.forename: Satoru
authors.initials: S
authors.lastname: Kawakami
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000601:surgery*; D004724:Endoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009392:Nephrectomy / Q000379:methods*