Retroperitoneal laparoscopic radical nephrectomy: experience of 23 cases.
BACKGROUND
Retroperitoneal laparoscopic radical nephrectomy has recently been performed in several institutions for renal cancer. We report our experience with this type of operation and discuss the anatomy of perirenal fascial structures.


METHODS
From July 2000 to May 2002, we performed retroperitoneal laparoscopic radical nephrectomy in 23 patients. We began this operation with longitudinal cutting of two layers of the posterior renal fasciae, and removed specimens without any fascial structure.


RESULTS
Mean operative time was 203 min (range 129-314 min) with an average estimated blood loss of 113 ml (range 0-837 ml). There was 1 patient who required open conversion due to uncontrollable hemorrhage, but no complication was observed.


CONCLUSIONS
Retroperitoneal laparoscopic radical nephrectomy is a safe and reliable method when the anatomy of the perirenal fasciae is clearly understood. Long-term follow-up of patients undergoing this procedure is warranted to its effect on the prognosis of renal cancer.
Yoshimura
Koji
K
Department of Urology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan. ky7527@kchnet.or.jp
Ichioka
Kentaro
K
Terada
Naoki
N
Matsui
Yoshiyuki
Y
Terai
Akito
A
Arai
Yoichi
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012187:Retroperitoneal Space