title: Early ligature of renal artery during radical laparoscopic transperitoneal nephrectomy: description of standard technique and direct access.
abstract: OBJECTIVE
  We compared two techniques of early ligature of the renal artery during transperitoneal laparoscopic radical nephrectomy: a standard technique and a direct approach to the artery.
  
  
  METHODS
  Of 100 patients undergoing transperitoneal laparoscopic radical nephrectomy at our institution, in the last 70, we used early renal-artery ligature. Of these, the standard technique after exposure of the vascular pedicle was used in 45 patients (group A), and ligature with a direct access to the renal artery was attempted in 25 patients (group B).
  
  
  RESULTS
  No statistical differences were noted between the two groups in terms of age, lesion size, operative time, estimated blood loss, or intraoperative and postoperative complications. There were no recurrences of disease by CT evaluation in either group during follow-up (range 1-46 months).
  
  
  CONCLUSIONS
  Transperitoneal laparoscopic radical nephrectomy with direct access to renal artery for early ligature is technically difficult but feasible and safe.
authors.affiliation: Divisione Universitaria di Urologia, Dipartimento di Scienze Cliniche e Biologiche, Università degli Studi di Torino, Ospedale "San Luigi," Orbassano (Torino), Italy. porpiglia@libero.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Porpiglia
authors.forename: Carlo
authors.initials: C
authors.lastname: Terrone
authors.forename: Cecilia
authors.initials: C
authors.lastname: Cracco
authors.forename: Marco
authors.initials: M
authors.lastname: Cossu
authors.forename: Susanna
authors.initials: S
authors.lastname: Grande
authors.forename: Francesca
authors.initials: F
authors.lastname: Musso
authors.forename: Julien
authors.initials: J
authors.lastname: Renard
authors.forename: Roberto Mario
authors.initials: RM
authors.lastname: Scarpa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011336:Probability; D012077:Renal Artery / Q000601:surgery*; D012187:Retroperitoneal Space; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler