World Journal of Laparoscopic Surgery

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VOLUME 1 , ISSUE 2 ( May-August, 2008 ) > List of Articles

RESEARCH ARTICLE

The Comparative Estimation Result Radical Nephrectomy Executed “Opened”, Laparoscopic and Laparoscopic Hand-assisted Access

OE Lucevich, EV Kamilov

Citation Information : Lucevich O, Kamilov E. The Comparative Estimation Result Radical Nephrectomy Executed “Opened”, Laparoscopic and Laparoscopic Hand-assisted Access. World J Lap Surg 2008; 1 (2):27-28.

DOI: 10.5005/jp-journals-10007-1055

Published Online: 01-08-2008

Copyright Statement:  Copyright © 2008; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aims

Improvement of results of treatment patients of malignant tumors of a kidney at use ORN, LRN and HALRN.

Materials and methods

Results of treatment of 120 patients with a cancer of a kidney in the age of from 32 till 77 years (middle age -54,6±8,4 years). Patients have been divided into three groups: in first group 60 (50%) patients it is executed ORN. In the second group at 26 (21.7%) by patients it is executed LRN. Into the third group have entered 34 (28.3%) the person by whom it is executed HALRN. The various steps for HALRN are shown in Figs 1 to 2A to C.

In the first group the size of a tumors has on the middle made 8.4 ± 1.2 sm, in the second group 6.7 ± 1.1 sm, and in the third group 7.1 ± 1.8 sm.

Results

At ORN middle operative time has made 135.7 ± 8.2 minute, with middle blood loss 274.3 ± 28.5 ml. The length of a operational cut has on the made 18.4 ± 2.3 sm. Duration of time invalidity has made 31.2 ± 7.6 day. Middle stay of the patient in hospital has made 16.8 ± 2.7 day.

At LRN middle operative time has made 122.6 ± 4.1 minute, with middle blood loss 115.4 ± 17.3 ml. The length of a operational cut has on the made 5.3 ± 0.4 sm. Duration of time invalidity has made 15.9 ± 4.1 day. Middle stay of the patient in hospital has made 6.2 ± 3.1 day.

At HALRN middle operative time has made 108.6 ± 10.3 minute, with middle blood loss 125.4 ± 15.2 ml. The length of a operational cut has on the middle made 6.7 ± 0.6 sm. Duration of time invalidity has made 17.6 ± 5.2 day. Middle stay of the patient in hospital has 7.8 ± 1.6 made day.

After ORN drainages established in a box of a kidney deleted on the average on 3. 4 ± 0.8 day, and after LRN and HALRN accordingly on 1.1 ± 0.2 and 1.3 ± 0.5 day after operation.

After ORN are noted next complications: at 47 (39.2%) patients infringement of skin sensitivity in the field of postoperation traces, at 29 (24.2%) asymmetry of a forward belly wall and 6 (5%) patients postoperation abdominal hernia. After LRN and HALRN in the postoperative period of patients' complications it is noted.

Conclusions

LRN and HALRN at a cancer of a kidney is the radical and quite justified intervention allowing essentially improving direct results of surgical treatment and quality of a life of the patient in remote terms.

Advantages LRN and HALRN are: good cosmetic effect, smaller blood loss, reduction of time of stay in a hospital and the general disability.

LRN and LRN provides good results even at III (T3N0- 1M0) stages of a cancer of a kidney that is caused by an opportunity of performance total lymphadenectomy and A reduction trauma fabrics during surgical intervention.


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