scholarly journals Open surgery versus retroperitoneal laparoscopic nephrectomy for renal tuberculosis: a retrospective study of 120 patients

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2708 ◽  
Author(s):  
Su Zhang ◽  
You Luo ◽  
Cheng Wang ◽  
Hu Xiong ◽  
Sheng-Jun Fu ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Open Surgery ◽  
Operation Time ◽  
Laparoscopic Nephrectomy ◽  
Renal Diseases ◽  
Renal Surgery ◽  
Preoperative Serum ◽  
Estimated Blood Loss ◽  
Renal Tuberculosis ◽  
Retroperitoneal Laparoscopic Nephrectomy

Background Laparoscopic renal surgery has been widely used in the treatment of renal diseases. However, there is still little research about its application in addressing renal tuberculosis. The purpose of this study is to retrospectively investigate the surgical results of laparoscopic and open surgery for nonfunctional tuberculous kidneys. Methods Between May 2011 and June 2016, 120 nephrectomies were performed in patients with a nonfunctional tuberculous kidney. Of these, 69 patients underwent retroperitoneal laparoscopic nephrectomy, and 51 patients underwent open nephrectomy. Data about the patients’ characteristics and surgical outcomes were collected from their electronic medical records. Outcomes were compared between these two groups. Results Our results showed that a number of renal tuberculosis patients presented no significant symptoms during their disease. Lower urinary tract symptoms (LUTS) were the most common at a rate of 73/120, followed by flank pain or accidently discovery (66/120), urine abnormality (30/120) and fever (27/120). Patients who underwent open surgery were similar to laparoscopic patients with regard to sex, BMI, location, previous tuberculous history, grade, anemia, adhesion, hypertension, diabetes and preoperative serum creatinine level, but were generally older than laparoscopic patients. There were no significant differences between open and laparoscopic surgery in estimated blood loss, transfusion, postoperative hospital days and perioperative complication rate. However, the median operation time of laparoscopic operation was much longer than open surgery (180 [150–225] vs 135 [120–165] minutes, P < 0.01). Seven of the 69 laparoscopic operations were converted to open surgery because of severe adhesions. Conclusion Laparoscopic nephrectomy is as an effective treatment as open surgery for a nonfunctional tuberculous kidney, although it requires more time during the surgical procedure. No significant differences in other surgical outcomes were observed.

Impact of an Ultrasonically Activated Device in Robot-Assisted Distal Gastrectomy

2017 ◽  
Vol 12 (6) ◽  
pp. 453-458
Author(s):  
Makoto Hikage ◽  
Masanori Tokunaga ◽  
Rie Makuuchi ◽  
Yutaka Tanizawa ◽  
Etsuro Bando ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Surgical Outcomes ◽  
Distal Gastrectomy ◽  
Operation Time ◽  
Patient Characteristics ◽  
Clinicopathological Characteristics ◽  
Robot Assisted ◽  
Estimated Blood Loss ◽  
Device Use

Objective Robot-assisted gastrectomy is increasingly used for the treatment of gastric cancer, although it remains a time-consuming procedure. An ultrasonically activated device might be useful to shorten operation times. This study therefore assessed the effect of ultrasonically activated device use on procedural times and on other early surgical outcomes. Methods Consecutive patients (N = 42) who underwent robot-assisted distal gastrectomy for gastric cancer were included. Clinicopathological characteristics and early surgical outcomes were compared between robotic-assisted gastrectomy procedures using an ultrasonically activated device (U group, n = 21) and those without it (NU group, n = 21). Results There were no significant differences in patient characteristics between the groups; however, the median operation time was significantly less in the U group than in the NU group (291 vs 351 minutes, P = 0.006). In detail, the median duration of console time until dividing the duodenum was less in the U group (70 vs 102 minutes, P < 0.001). Estimated blood loss, incidence of postoperative morbidity, and duration of postoperative hospital stay were not different between the groups. Conclusions An ultrasonically activated device reduced the operation time of robot-assisted gastrectomy without increasing blood loss and morbidity.

Selecting the surgical approach in complex reoperative partial nephrectomies: Does robotics have a role?

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 658-658
Author(s):  
Sandeep Gurram ◽  
Siobhan Telfer ◽  
Winston Li ◽  
Heather Chalfin ◽  
W. Marston Linehan ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Robotic Surgery ◽  
Surgical Approach ◽  
Open Surgery ◽  
Perioperative Outcomes ◽  
Open Approach ◽  
Renal Surgery ◽  
Estimated Blood Loss ◽  
Operative Complications ◽  
Post Operative Complications

658 Background: Minimally invasive surgery (MIS) has shown equal oncologic efficacy as the open approach for treating small renal masses but results in improved perioperative parameters. Surgical principles also dictate that the open technique should be considered when facing difficult surgeries though this is experience and not evidenced based. The goal of our study is to explore differences in outcomes amongst open or robotic approaches in complex reoperative partial nephrectomies. Methods: 194 patients who had prior renal surgery from 2008 to 2019 were identified, the majority of which presented with multiple tumors due to known or suspected hereditary kidney cancer syndrome. Patients were stratified into the following cohorts based on surgical history: open after open surgery, open after MIS, robotic after open surgery, and robotic after MIS. Perioperative outcomes were compared amongst cohorts. Results: Significant differences were noted in estimated blood loss (EBL), number of tumors resected, and postoperative complications as assessed by Clavien score. Univariate regression analysis of EBL showed that the number of tumors resected (p <.0001, coefficient: 111 ml), number of prior renal procedures (p=.012, coefficient: 419 ml), hilar clamping (p = .015, coefficient: 840 ml), and intended surgical approach (p = .001; coefficient: 905 ml) were significant. On multivariate analysis, number of tumors resected (p<.0001, coefficient: 97 ml) was the only significant factor. Univariate analysis on post-operative complications showed that number of prior surgeries (p = 0.03, OR: 1.5) and final intended approach (p < .0001, OR: 4.6) were significant. On multivariate analysis, the final intended surgical approach (p = .001, OR: 4.3) was shown to be significant. Conclusions: These data show that the surgical approach of prior procedures is not a significant factor that affects perioperative outcomes, but the use of robotic surgery was associated with decreased post-operative complications in reoperative renal surgery . While open surgery will likely continue to be the standard of care for complex reoperative procedures, these data suggest that robotic surgery is safe and well tolerated in select cases.

A Simple Predictive Index of the Abdominal Shape for Postoperative Complications After Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer

2021 ◽  
Author(s):  
Wei Tao ◽  
Yuxi Cheng ◽  
Xiao-Yu Liu ◽  
Bin Zhang ◽  
Chao Yuan ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Surgical Outcomes ◽  
Distal Gastrectomy ◽  
Subcutaneous Fat ◽  
Operation Time ◽  
Short Term ◽  
Predictive Index ◽  
Xiphoid Process ◽  
Estimated Blood Loss ◽  
Abdominal Shape

Abstract Purpose The purpose of this study was to explore the effect of abdominal shape on the short-term surgical outcomes of laparoscopic distal gastrectomy + D2 lymph node dissection (LADG). Methods This was a retrospective study that included 425 patients undergoing LADG from January 2013 to January 2021 at a single clinical center. The abdominal parameters, including the shortest distance of the pancreas from the anterior abdominal skin (PAAD), the lower sternum angle (LSA), the thickness of the subcutaneous fat at the navel level (SFT), the anteroposterior diameters (APD) and the left-right diameters (LRD) at the navel level, the distance from the xiphoid process to the navel (XND) and the distance from the xiphoid process to the pubis (XBD), were calculated by preoperative abdominal computed tomography (CT) imaging. The abdominal parameters and short-term surgical outcomes were analyzed. Results In males, the number of retrieved lymph nodes was significantly higher in patients with a lower APD group (p=0.031). The operation time was significantly shorter in the lower body mass index (BMI) (p=0.007), lower LSA (p=0.035), lower PAAD (p=0.000), lower SFT (p=0.004), lower APD (p=0.000) and lower LRD (p=0.014) groups. The estimated blood loss was significantly less in the lower BMI (p=0.035), lower LSA (p=0.001), lower PAAD (p=0.012), lower SFT (p=0.003), lower APD (p=0.000) and lower LRD (p=0.005) groups. The complications were fewer in the lower LSA (p=0.012), lower APD (p=0.043) and lower LRD (p=0.023) groups. In females, the postoperative hospital stay was shorter in the lower PAAD (p=0.027) and lower SFT (p=0.004) groups, and the lower SFT group had fewer complications (p=0.020). Furthermore, in multivariate analysis, higher PAAD (p=0.029, odds ratio=1.030, 95% CI=1.003-1.058) was an independent factor for predicting postoperative complications in males. Conclusion Various abdominal shapes can affect the difficulty of LADG. Higher PAAD is a simple independent index for predicting postoperative complications in males.

Retroperitoneal Laparoscopic Nephrectomy for Inflammatory Renal Diseases

2008 ◽  
Vol 49 (2) ◽  
pp. 107
Author(s):  
Hyun Kee Cho ◽  
Doo Sang Kim ◽  
Dong Soo Ryu ◽  
Tae Hee Oh ◽  
Youn Soo Jeon
Keyword(s):  
Laparoscopic Nephrectomy ◽  
Renal Diseases ◽  
Retroperitoneal Laparoscopic Nephrectomy

scholarly journals Outcome of laparoscopic nephrectomy in benign renal disease

2016 ◽  
Vol 3 (2) ◽  
pp. 19-22
Author(s):  
Naresh Kumar Giri ◽  
Narayan Thapa ◽  
Bikash Bikram Thapa ◽  
Bharat Bahadur Bhandari ◽  
Bhairab Kumar Hamal
Keyword(s):  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Stone Disease ◽  
Laparoscopic Nephrectomy ◽  
Renal Diseases ◽  
Median Hospital Stay ◽  
Estimated Blood Loss ◽  
Median Hospital

Introductions: Laparoscopic surgery is a rapidly emerging option in urology. With the advances in technology and instruments, currently this is viable alternative to treat complex surgical diseases as well as reconstructive surgery.Methods: This was a prospective observational study to analyze the outcome of laparoscopic nephrectomy. A total of 51 patients had undergone laparoscopic nephrectomy over the period of five years. The variables analyzed were, age, sex, operative time, estimated blood loss, length of hospital stay, conversion rate and complication.Results: The patients’ mean age was 41.1 years (range 15-71 years). Indications for nephrectomy were non-functional kidney secondary to stone disease in 26 (50.98%). Mean operative time was 1.43 hours. Median hospital stay was 2.3 days.Conclusions: Laparoscopic surgery is a safe and feasible treatment option for benign renal diseases with comparable outcomes. Non- functional kidney secondary to renal stone was the major cause of nephrectomy in this study. Journal of Patan Academy of Health  Sciences. 2016 Dec;3(2):19-22 

scholarly journals A Simple Predictive Index of the Abdominal Shape for Postoperative Complications After Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer

2021 ◽  
Vol 8 ◽  
Author(s):  
Wei Tao ◽  
Yu-Xi Cheng ◽  
Xiao-Yu Liu ◽  
Bin Zhang ◽  
Chao Yuan ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Surgical Outcomes ◽  
Distal Gastrectomy ◽  
Subcutaneous Fat ◽  
Operation Time ◽  
Short Term ◽  
Predictive Index ◽  
Xiphoid Process ◽  
Estimated Blood Loss ◽  
Abdominal Shape

Background: The purpose of this study was to explore the effect of abdominal shape on the short-term surgical outcomes.Methods: This was a retrospective study that included 425 patients undergoing laparoscopic distal gastrectomy plus D2 lymph node dissection (LADG) from January 2013 to January 2021. The abdominal parameters, including the shortest distance of the pancreas from the anterior abdominal skin (PAAD), the lower sternum angle (LSA), the thickness of the subcutaneous fat at the navel level (SFT), the anteroposterior diameters (APD) and the left-right diameters (LRD) at the navel level, the distance from the xiphoid process to the navel (XND) and the distance from the xiphoid process to the pubis (XBD), were calculated by preoperative abdominal computed tomography (CT) imaging. The parameters and short-term surgical outcomes were analyzed.Results: In males, the number of retrieved lymph nodes was significantly higher in patients with a lower APD group (p = 0.031). The operation time was significantly shorter in the lower body mass index (BMI) (p = 0.007), lower LSA (p = 0.035), lower PAAD (p = 0.000), lower SFT (p = 0.004), lower APD (p = 0.000) and lower LRD (p = 0.014) groups. The estimated blood loss was significantly less in the lower BMI (p = 0.035), lower LSA (p = 0.001), lower PAAD (p = 0.012), lower SFT (p = 0.003), lower APD (p = 0.000) and lower LRD (p = 0.005) groups. The complications were fewer in the lower LSA (p = 0.012), lower APD (p = 0.043) and lower LRD (p = 0.023) groups. In females, the postoperative hospital stay was shorter in the lower PAAD (p = 0.027) and lower SFT (p = 0.004) groups, and the lower SFT group had fewer complications (p = 0.020). Furthermore, in multivariate analysis, higher PAAD (p = 0.037, odds ratio = 1.030, 95% CI = 1.002–1.059) was an independent factor for predicting postoperative complications in males.Conclusion: Various abdominal shapes can affect the difficulty of LADG. Higher PAAD is a simple independent index for predicting postoperative complications in males.

MP-06.08: Retroperitoneal laparoscopic nephrectomy for inflammatory renal diseases

Urology ◽  
2007 ◽  
Vol 70 (3) ◽  
pp. 68
Author(s):  
Y.S. Jeon ◽  
T.H. Oh ◽  
D.S. Kim ◽  
C.H. Lee ◽  
N.K. Lee
Keyword(s):  
Laparoscopic Nephrectomy ◽  
Renal Diseases ◽  
Retroperitoneal Laparoscopic Nephrectomy
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