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Laparoscopic nephrectomy: an early experience
at Queen Mary Hospital
MC Cheung, FCW Lee, SM Chu,
YL Leung, BBW Wong, KL Ho, PC Tam
Division of Urology, Department of Surgery, Queen Mary Hospital,
102 Pokfulam Road, Hong Kong
OBJECTIVE. To report our early experience of laparoscopic
nephrectomy.
DESIGN. Prospective data collection.
SETTING. Queen Mary Hospital, Hong Kong.
PATIENTS. Transperitoneal laparoscopic nephrectomies
were performed on 40 patients between July 1997 and December 2002.
MAIN OUTCOME MEASURES. Demographic and perioperative
data including operating time, blood loss, postoperative pain score,
analgesic requirement, complications, time to resume oral intake,
ambulatory state, and length of hospital stay.
RESULTS. Laparoscopic nephrectomy was performed
for 21 solid renal masses, five transitional cell carcinomas, and
14 non-functioning kidneys. Seven (17.5%) patients had previous
abdominal surgery. The mean body mass index of the patients was
23.9 kg/m(2) and the mean operating time was
229 minutes. The mean estimated blood loss was 370 mL, and two patients
required conversion to open surgery because of intra-operative bleeding.
Other complications include diaphragmatic injury, port-site bleeding,
chyle leakage, bleeding peptic ulcer, and myocardial ischaemia.
The postoperative mean analgesic requirement was 26 mg of morphine
sulphate equivalent. The mean time for patients to resume oral diet
and full ambulation was 1.3 and 2.8 days, respectively, and the
mean length of hospital stay was 6.7 days. The mean diameter of
the solid renal tumour was 4.1 cm and the surgical margins of all
resected specimen for malignant tumours were negative.
CONCLUSION. Laparoscopic nephrectomy is a safe and
efficacious approach for resection of benign non-functioning kidneys
and malignant renal tumours.
Hong Kong Med J 2005;11:7-11
Key words: Kidney neoplasms; Laparoscopy; Nephrectomy;
Surgical procedures, minimally invasive
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