Efficacy Observation of Hand-Assisted Laparoscopic Converted from Retroperitoneal Laparoscopy Partial Nephrectomy

ZHAO Guo-bin; LI Xiang-dong; TANG Yu-hong; KONG Yan-ping; ZHANG Xiu-mei; MIAO Wen-long; LING Hai-bin; ZHANG Chao

doi:10.3969/j.issn.1002-3429.2015.06.015

Abstract：Objective To observe the clinical results of hand-assisted laparoscopic partial nephrectomy converted from retroperitoneal laparoscopy. Methods During 2009 Feb. And 2013 Feb. , 27 patients underwent retroperitoneal lapa-roscopy partial nephrectomy, and operative style conversion for adhesion, bleeding, complex tumor location, etc. Randomly divided into two groups, 14 cases were converted to hand-assisted laparoscopic, and 13 to open surgeries. The tumor sizes , surgery time, loss of blood, incision length, off bed time, postoperative hospital stay, and renal ischemia time, prognosis, and concentration of CRP and IL-6 were compare. Results All the 27 operations were performed successfully. The surgery time, bleeding amount, incision length and off bed time of hand-assisted laparoscopic group were all less than that of open sur-gery group(P<0. 01 or P<0. 05);but renal ischemia time was longer than that of open surgery group, and the differences showed no statistical significance( P>0. 05 ) . The concentration of CRP and IL-6 on postoperative 1 d and 3 d of the two groups were significantly higher than the preoperative level(P<0. 01), but The concentration of CRP and IL-6 post-operation of hand assisted laparoscopic group were significantly lower than that of open surgery group (P<0. 01). In the open operation group there was 1 case of vena cava injury, and after intraoperative repair, patients of two groups had no complications after. Two groups were followed up for 10-58 months, no recurrence was found. Conclusion Retroperitoneal laparoscopy partial ne-phrectomy converted into hand-assisted laparoscopic is less invasive with less loss of blood but a quicker recovery.