Laparoscopic partial nephrectomy with diode laser: a promising technique

Knežević, Nikola and Kuliš, Tomislav and Marić, Marjan and Topalović Grković, Marija and Krhen, Ivan and Kaštelan, Željko (2014) Laparoscopic partial nephrectomy with diode laser: a promising technique. Photomedicine and Laser Surgery, 32 (2). pp. 101-105. ISSN 1549-5418

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OBJECTIVE: The aim of this study was to evaluate application of diode laser in laparoscopic partial nephrectomy (LPN), and to question this technique in terms of ease of tumor excision and reduction of warm ischemia time (WIT). ----- BACKGROUND DATA: LPN is the standard operative method for small renal masses. The benefits of LPN are numerous, including preserving renal function and prolonging overall survival. However, reduction of WIT remains main challenge in this operation. In order to shorten WIT, many techniques have been developed, with variable results. ----- PATIENTS AND METHODS: We performed a prospective collection and analysis of health records for patients who were operated on between March 2011 and August 2012. Inclusion criteria were single tumor ≤ 4 cm, predominant exophytic growth and intraparenchymal depth ≤ 1.5 cm, with a minimum distance of 5 mm from the urinary collecting system. ----- RESULTS: We operated on 17 patients. Median operative time was 170 min. In all but two patients, we had to perform hilar clamping. Median duration of WIT was 16 min. Pathohistological evaluation revealed clear cell renal cancer and confirmed margins negative for tumor in all cases. Median size of the tumor was 3 cm. Median postoperative hospitalization was 5 days. Average follow up was 11.5 months. There were no intraoperative complications. One postoperative complication was noted: perirenal hematoma. ----- CONCLUSIONS: Laser LPN is feasible, and offers the benefit of shorter WIT, with effective tissue coagulation and hemostasis. With operative experience and technical advances, WIT will be reduced or even eliminated, and a solution to some technical difficulties, such as significant smoke production, will be found.

Item Type: Article
Additional Information: Copyright 2014, Mary Ann Liebert, Inc.
MeSH: Adult ; Aged ; Carcinoma, Renal Cell/surgery ; Female ; Humans ; Kidney Neoplasms/radiography ; Kidney Neoplasms/surgery ; Laparoscopy ; Laser Therapy/methods ; Male ; Middle Aged ; Nephrectomy/methods ; Tomography, X-Ray Computed ; Warm Ischemia
Departments: Katedra za urologiju
Depositing User: Marijan Šember
Status: Published
Knežević, NikolaUNSPECIFIED
Kuliš, TomislavUNSPECIFIED
Topalović Grković, MarijaUNSPECIFIED
Kaštelan, ŽeljkoUNSPECIFIED
Date: February 2014
Date Deposited: 29 Oct 2015 10:02
Last Modified: 17 Jul 2020 08:21
Subjects: /
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