Korean J Urol KJU Korean Journal of Urology 0494-4747 The Korean Urological Association 10.4111/kju.2006.47.9.968 Original Article Laparoscopic Transperitoneal Radical Nephrectomy for Treating of Renal Cell Carcinoma Lee Yong Seong Lee Young Hoon Han Woong Kyu Soh Byung Heon Yang Seung Choul Rha Koon Ho Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. Corresponding author (khrha@yumc.yonsei.ac.kr) 09 2006 30 09 2006 47 9 968 973 08 02 2006 21 07 2006 Copyright © 2006 The Korean Urological Association 2006 Purpose

Laparoscopic radical nephrectomy has emerged as a feasible treatment option for patients with clinically localized renal cell carcinoma. We evaluated the clinical efficacy and oncologic safety of laparoscopic radical nephrectomy.

 Materials and Methods

Between April 2004 and October 2005, 31 laparoscopic radical nephrectomies were performed for clinically localized, stages cT1/2 NXMX, pathologically confirmed renal cell carcinoma. The clinical parameters including the operative time and the learning curve, the estimated blood loss, the postoperative hospital stay and the recurrence rate were evaluated.

 Results

All procedures were completed laparoscopically via transperitoneal approach. There were no complications. The mean operative time was 140.6 minutes (range: 80-270) and the mean blood loss was 230.4ml (range: 30-800). The mean postoperative hospital stay was 4.9 days (range: 3-9) and all patients had satisfactory outcomes with objective cure on the follow up imaging studies. No patient had laparoscopic port site, wound or renal fossa tumor recurrence during the follow up periods (mean: 13 months).

 Conclusions

Laparoscopic transperitoneal radical nephrectomy can be a safe and effective treatment. It could be considered as a primary procedure for treating localized renal cell carcinoma.

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Laparoscopic view of renal hilar vessels handling. (A) Dissected left renal artery and vein after the ligation and division of the gonadal vein, (B) renal artery ligation and division with using a 12-mm EndoGIA® stapler.

Laparoscopic radical nephrectomy 31-case operative (OR) time.

Clinical characteristics

LRN: laparoscopic radical nephrectomy, ORN: open radical nephrectomy, BMI: body mass index

Operative results

LRN: laparoscopic radical nephrectomy, ORN: open radical nephrectomy

Operative outcomes of laparoscopic radical nephrectomy

EBL: estimated blood loss, TP: transperitoneal, RP: retroperitoneal, NS: not stated