Laparoscopic transmesenteric partial nephrectomy

Kochkin A.D., Sevryukov F.A., Martov A.G., Knutov A.V., Semenychev D.V., Sergeev V.P., Novikov A.B., Orlov I.N.

This paper presents the results of a series tansmezenteriс kidney resection and compares to standard laparoscopic technique. The basis of the study served as a retrospective analysis of the results of surgical treatment of 61 patients with tumors in the left kidney T1NoMo stage, subjected to laparoscopic partial nephrectomy in the period 2012-2015 years. 

Study group consisted of 29 patients operated from transmezenteric access. The control group consisted of 32 patients operated by the method of standard laparoscopic partial nephrectomy. The frequency and structure of intraand postoperative complications, time of warm ischemia, operation and length of stay of patients in hospital. Were studied mortality and conversion were avoided. Intraoperative complications in the group transmezenteric partial nephrectomy were observed. In turn, this has happened twice (6.25%) in the standard surgery group. In the transmezenteric resection group time ischemia averaged 18 ± 3 minutes, and in the control group 20 ± 5 minutes (p> 0.05). In turn, the duration of the operation through the "window" in the mesentery reached 110 [90-120] minutes, the standard access group 120 [90-130] min (p> 0.05). Postoperative complications were comparable in both groups. Indicators of postoperative hospital stay are identical and amounted to 7 ± 0,8 and 7 ± 0,8 bed-days in the study group and comparison respectively (p> 0.05). 

Transmezenteric access using leds to a natural reduction in operation time and the number of intraoperative complications, due to the lack of need for the mobilization of the descending colon. However, a limited number of observations does not allow us to conduct a qualitative analysis of the correlation between the time of surgery, intraoperative complications and characteristics of tumors on a scale R.E.N.A.L. 

Authors declare lack of the possible conflicts of interests. 

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transmesocolic approach, transmesocolic partial nephrectomy, renal cell carcinoma