title: Retroperitoneoscopic radical nephrectomy with a small incision for renal cell carcinoma: comparison with the conventional method.
abstract: OBJECTIVE
  When retroperitoneoscopic radical nephrectomy for renal cell carcinoma was introduced into our institution, we performed a combined small skin incision method. In this method, a small incision was made to approach the retroperitoneal space prior to setting trockers and thereafter a LAPDISC was placed in the incision to start the retroperitoneoscopic procedure. In this study, we compared the outcomes between the combined small skin incision method ("A method" hereinafter) and the conventional method ("B method" hereinafter).
  
  
  METHODS
  Among the cases of T1N0M0 suspicious renal cell carcinoma treated at Yokohama City University between May 2003 and June 2009, the A method was performed in 51 cases and the B method was performed in 33 cases. The factors in the outcomes compared between the A and B methods were the duration of procedure, volume of bleeding, volume of transfusion, weight of the specimen, incidence of peritoneal injury, rate of conversion to open surgery, and perioperative complications.
  
  
  RESULTS
  The duration of the procedure was 214.4 ± 46.9 minutes in the A method group and 208.1 ± 36.4 minutes in the B method group (p = 0.518). The volume of bleeding and the weight of the specimen were 105.5 ± 283.2 ml and 335.1 ± 137.4 g in the A method group and 44.8 ± 116 ml (p = 0.247) and 309.2 ± 126 g (p = 0.385) in the B method group. There was no significant difference in all factors analyzed.
  
  
  CONCLUSIONS
  The A method would be highly possible to produce stable results, even during the introduction period when the staff and the institution are still unfamiliar with the retroperitoneoscopic surgery.
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine and School of Medicine, Yokohama, Japan. pug_daikichi@yahoo.co.jp
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ito
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Makiyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawahara
authors.forename: Futoshi
authors.initials: F
authors.lastname: Sano
authors.forename: Takayuki
authors.initials: T
authors.lastname: Murakami
authors.forename: Narihiko
authors.initials: N
authors.lastname: Hayashi
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Miyoshi
authors.forename: Noboru
authors.initials: N
authors.lastname: Nakaigawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yao
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kubota
mesh_terms: D002292:Carcinoma, Renal Cell / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D009392:Nephrectomy / Q000379:methods*; D012187:Retroperitoneal Space; D016896:Treatment Outcome