Initial experience with transperitoneal laparoscopic nephrectomy in an Irish hospital setting.
Forde, J C McGuire, B B Lawson, M B Power, R E
Forde, J C
McGuire, B B
Lawson, M B
Power, R E
Authors
Advisors
Editors
Other Contributors
Date
2009-08
Date Submitted
Keywords
Other Subjects
Subject Mesh
Adult
Aged
Cohort Studies
Female
Humans
Ireland
Kidney Neoplasms
Laparoscopy
Male
Middle Aged
Nephrectomy
Retrospective Studies
Surgical Stapling
Treatment Outcome
Young Adult
Aged
Cohort Studies
Female
Humans
Ireland
Kidney Neoplasms
Laparoscopy
Male
Middle Aged
Nephrectomy
Retrospective Studies
Surgical Stapling
Treatment Outcome
Young Adult
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
Laparoscopic nephrectomy has gained widespread acceptance as a treatment for both benign and malignant conditions and is becoming increasingly popular in Irish hospitals. We report a single surgeon, single centre experience with 20 consecutive laparoscopic nephrectomies comparing them to 20 open cases performed prior to the establishment of a laparoscopic service.
A retrospective comparative analysis was carried out over an 18 month period. Transperitoneal approach was used in the laparoscopic group with renal vessels divided using an Endo GIA stapling device. Parameters examined included age, weight, indication, operative time, blood loss, tumour size, length of stay and analgesic requirements. Comparison was made with 20 open nephrectomies.
Mean age (p=0.26) and weight (p=0.08) were similar in both groups. Average tumour size was similar (4.98 cm [range 2.8-9] in laparoscopic group versus 6.4 cm [range 3-10], p=0.61). Mean operative blood loss was reduced in the laparoscopic group (65 ml (range 50-200) versus 351 ml (50-1740) (p=or<0.05 L.N. versus O.N.). Laparoscopic patients were discharged earlier; 3.9 days (range 3-6) versus 6.5 (range 5-11) postoperatively (p=or<0.05 L.N. versus O.N.). Analgesia requirements were reduced in terms of both total hours using PCA (25.05 hours [range 1-45] versus 41.6 hours (range 7-226)) (p=or<0.05 L.N. versus O.N.) and total morphine requirements (35.5 mg [range 2-94] versus 72.4 mg [range 18-113] [p=or<0.05 L.N. versus O.N.]). There were no complications in the laparoscopic group, while one patient developed an incisional hernia in the open group.
Laparoscopic nephrectomy is less invasive and demonstrates improved results in terms of analgesia, blood loss and reduced overall stay.
A retrospective comparative analysis was carried out over an 18 month period. Transperitoneal approach was used in the laparoscopic group with renal vessels divided using an Endo GIA stapling device. Parameters examined included age, weight, indication, operative time, blood loss, tumour size, length of stay and analgesic requirements. Comparison was made with 20 open nephrectomies.
Mean age (p=0.26) and weight (p=0.08) were similar in both groups. Average tumour size was similar (4.98 cm [range 2.8-9] in laparoscopic group versus 6.4 cm [range 3-10], p=0.61). Mean operative blood loss was reduced in the laparoscopic group (65 ml (range 50-200) versus 351 ml (50-1740) (p=or<0.05 L.N. versus O.N.). Laparoscopic patients were discharged earlier; 3.9 days (range 3-6) versus 6.5 (range 5-11) postoperatively (p=or<0.05 L.N. versus O.N.). Analgesia requirements were reduced in terms of both total hours using PCA (25.05 hours [range 1-45] versus 41.6 hours (range 7-226)) (p=or<0.05 L.N. versus O.N.) and total morphine requirements (35.5 mg [range 2-94] versus 72.4 mg [range 18-113] [p=or<0.05 L.N. versus O.N.]). There were no complications in the laparoscopic group, while one patient developed an incisional hernia in the open group.
Laparoscopic nephrectomy is less invasive and demonstrates improved results in terms of analgesia, blood loss and reduced overall stay.
Language
en
ISSN
1479-666X
eISSN
ISBN
DOI
PMID
19736887