title: Retroperitoneoscopic partial nephrectomy with transient occlusion of renal artery for treatment of small renal tumors.
abstract: OBJECTIVE
  To evaluate the results of retroperitoneoscopic partial nephrectomy with transient occlusion of the renal artery for treatment of patients with small renal tumors.
  
  
  METHODS
  From May 2002 to March 2003, 12 consecutive patients with T1N0M0 renal tumors with a median diameter of 3.0 cm underwent retroperitoneoscopic partial nephrectomy. The renal artery was clamped transiently without occlusion of the renal vein and the tumor was excised with scissors. Intracorporeal renal cooling was achieved by cold saline perfusion of the renal pelvis through a single-J ureteral catheter. Hemostasis was achieved by approximating the renal parenchyma over the perirenal fatty tissue using a retroperitoneoscopic suturing technique.
  
  
  RESULTS
  Of the 12 patients, 11 successfully underwent partial nephrectomy retroperitoneoscopically. The median operative time, renal ischemic time, and amount of blood loss in the successful procedures was 220 minutes (range 132 to 340), 50 minutes (range 16 to 115), and 150 mL (range 50 to 800), respectively. The renal calix was opened and repaired in 10 patients. The surgical margin was negative in all patients. The postoperative course was uneventful in all patients, and the return to work was achieved in a median of 18 days (range 9 to 39). The renal function of the affected kidney was well preserved postoperatively, when examined by renal scintigraphy. Neither local recurrence nor distant metastasis was found during the median follow-up period of 10 months (range 1 to 18).
  
  
  CONCLUSIONS
  Retroperitoneoscopic partial nephrectomy with transient occlusion of the renal artery is a useful and less-invasive method for resection of small renal tumors. Additional technologic developments to reduce ischemic times and to cool the kidneys laparoscopically are required.
authors.affiliation: Department of Urology, Kansai Medical University, Moriguchi, Osaka, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuda
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Oguchi
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yanishi
authors.forename: Shouichi
authors.initials: S
authors.lastname: Fukui
authors.forename: Gen
authors.initials: G
authors.lastname: Kawa
authors.forename: Koei
authors.initials: K
authors.lastname: Muguruma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D003250:Constriction; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007036:Hypothermia, Induced; D007432:Intraoperative Period; D007511:Ischemia / Q000209:etiology; D007668:Kidney / Q000098:blood supply; D052177:Kidney Diseases, Cystic / Q000473:pathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012074:Remission Induction; D012077:Renal Artery; D012187:Retroperitoneal Space; D013536:Suture Techniques; D016896:Treatment Outcome