Open Access

Improved laparoscopic nephron-sparing surgery for renal cell carcinoma based on the precise anatomy of the nephron

  • Authors:
    • Gang Guo
    • Wei Cai
    • Xu Zhang
  • View Affiliations

  • Published online on: September 21, 2016     https://doi.org/10.3892/ol.2016.5159
  • Pages: 3799-3803
  • Copyright: © Guo et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to investigate a method of laparoscopic nephron-sparing surgery (LNSS) for renal cell carcinoma (RCC) based on the precise anatomy of the nephron, and to decrease the incidence of hemorrhage and urinary leakage. Between January 2012 and December 2013, 31 patients who presented to the General Hospital of the People's Liberation Army (Beijing, China) were treated for RCC. The mean tumor size was 3.4±0.7 cm in diameter (range, 1.2-6.0 cm). During surgery, the renal artery was blocked, and subsequently, an incision in the renal capsule and renal cortex was performed, at 3‑5 mm from the tumor edge. Subsequent to the incision of the renal parenchyma, scissors with blunt and sharp edge were used to separate the base of the tumor from the normal renal medulla, in the direction of the ray medullary in the renal pyramids. The basal blood vessels were incised following the hemostasis of the region using bipolar coagulation. The minor renal calyces were stripped carefully and the wound was closed with an absorbable sutures. The arterial occlusion time, duration of surgery, intraoperative bleeding volume, post‑operative drainage volume, pathological results and complications were recorded. The surgery was successful for all patients. The estimated average intraoperative bleeding volume was 55.7 ml, the average surgical duration was 95.5 min, the average arterial occlusion time was 21.2 min, the average post‑operative drainage volume was 92.3 ml and the average post‑operative length of hospital stay was 6.1 days. No hemorrhage or urinary leakage was observed in the patients following the surgery. LNSS for RCC based on the precise anatomy of the nephron was concluded to be effective and feasible. The surgery is useful for the complete removal of tumors and guarantees a negative margin, which may also decrease the incidence of hemorrhage and urinary leakage following surgery.
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November-2016
Volume 12 Issue 5

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Guo G, Cai W and Zhang X: Improved laparoscopic nephron-sparing surgery for renal cell carcinoma based on the precise anatomy of the nephron. Oncol Lett 12: 3799-3803, 2016
APA
Guo, G., Cai, W., & Zhang, X. (2016). Improved laparoscopic nephron-sparing surgery for renal cell carcinoma based on the precise anatomy of the nephron. Oncology Letters, 12, 3799-3803. https://doi.org/10.3892/ol.2016.5159
MLA
Guo, G., Cai, W., Zhang, X."Improved laparoscopic nephron-sparing surgery for renal cell carcinoma based on the precise anatomy of the nephron". Oncology Letters 12.5 (2016): 3799-3803.
Chicago
Guo, G., Cai, W., Zhang, X."Improved laparoscopic nephron-sparing surgery for renal cell carcinoma based on the precise anatomy of the nephron". Oncology Letters 12, no. 5 (2016): 3799-3803. https://doi.org/10.3892/ol.2016.5159