title: [Laparoscopic radical nephrectomy for renal cell carcinoma at Kobe City General Hospital].
abstract: Between April 2002 and March 2004, 21 patients with clinical T1-T3a renal cell carcinoma underwent laparoscopic radical nephrectomy at the Kobe City General Hospital. A transperitoneal approach was chosen in 9 patients with clinical T2 stage, tumors more than 5 cm in diameter at the upper pole of the kidney, and posteriorly protruded tumors at the middle portion. Otherwise, a retroperitoneal approach was chosen in 12 patients. The mean (range) operative time for the transperitonal and retroperitoneal approaches was 355 (290-410) min and 342 (275-490) min, respectively. There were no major intraoperative complications. Postoperatively, one patient underwent emergency operation due to the perforation of duodenal ulcer. In the mean follow-up of 15.9 months, lung metastasis was seen in one patient under adjuvant immunotherapy. Significant differences between transperitoneal and retroperitoneal approaches were seen in mean time to renal artery clipping (170 versus 85 min, p < 0.01), mean blood loss (548 versus 281 ml, p < 0.05) and concurrent adrenalectomy (66.7 versus 16.7%, p < 0.05). Laparoscopic radical nephrectomy is a safe and feasible procedure when suitable approaches are chosen depending on tumor size and location.
authors.affiliation: The Department of Urology, Kobe City General Hospital.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Negoro
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shiraishi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sugino
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwamura
authors.forename: Seiji
authors.initials: S
authors.lastname: Moroi
authors.forename: Hiroya
authors.initials: H
authors.lastname: Oka
authors.forename: Mutsushi
authors.initials: M
authors.lastname: Kawakita
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*