Endoscopic minilaparotomy partial nephrectomy for solitary renal cell carcinoma smaller than 4 cm.
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.
Kageyama
Yukio
Y
Department of Urology and Reproductive Medicine, Graduate School Tokyo Medical and Dental University, Tokyo, Japan. kageyys.uro@tmd.ac.jp
Kihara
Kazunori
K
Yokoyama
Minato
M
Sakai
Yasuyuki
Y
Koga
Fumitaka
F
Saito
Kazutaka
K
Yano
Masataka
M
Arai
Gaku
G
Hyochi
Nobuhiko
N
Masuda
Hitoshi
H
Fujii
Yasuhisa
Y
Kawakami
Satoru
S
Kobayashi
Tsuyoshi
T
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*