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Japanese Journal of Clinical Oncology 32:417-421 (2002)
© 2002 Foundation for Promotion of Cancer Research

Endoscopic Minilaparotomy Partial Nephrectomy for Solitary Renal Cell Carcinoma Smaller than 4 cm

Yukio Kageyama, Kazunori Kihara, Minato Yokoyama, Yasuyuki Sakai, Fumitaka Koga, Kazutaka Saito, Masataka Yano, Gaku Arai, Nobuhiko Hyochi, Hitoshi Masuda, Yasuhisa Fujii, Satoru Kawakami and Tsuyoshi Kobayashi+

Department of Urology and Reproductive Medicine, Graduate School Tokyo Medical and Dental University, Tokyo, Japan

Background: For small, incidentally discovered renal cell carcinoma, partial nephrectomy is becoming more widely accepted as an alternative to radical nephrectomy and the need for minimally invasive approach is increasing.

Methods: We carried out endoscopic minilaparotomy partial nephrectomy in seven cases of solitary renal cell carcinoma smaller than 4 cm. Five of them were without renal pedicle clamping. All procedures were done through single skin incision (5–8 cm) using a 30° telescope. Hemostasis was achieved with a harmonic scalpel, a microwave tissue coagulator, an argon beam coagulator and autologous fibrin glue.

Results: There were no perioperative complications. All patients had negative surgical margins. The operating time was 157–275 min (average 209 min). The blood loss was 20–1200 ml (average 525 ml). Postoperatively, renal function as assessed by serum creatinine was within normal limits. Neither local recurrences nor metastases were observed during a follow-up of 6–15 months. The postoperative course was markedly improved over that expected from standard open surgery.

Conclusions: With minimal morbidity and complications, endoscopic minilaparotomy partial nephrectomy is feasible for small renal cell carcinoma.

+ For reprints and all correspondence: Yukio Kageyama, Department of Urology and Reproductive Medicine, Graduate School Tokyo Medical and Dental University, 1–5–45 Yushima, Bunkyo-ku, 113-8519 Tokyo, Japan. E-mail: kageyys.uro@tmd.ac.jp


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