Laparoscopic nephrectomy, ex vivo excision and autotransplantation for complex renal tumors

The Journal of Urology
Maxwell V MengMarshall L Stoller

Abstract

In many patients partial nephrectomy is the preferred alternative to radical nephrectomy for upper urinary tract cancers. We describe the use of laparoscopic nephrectomy, ex vivo excision and reconstruction, and autotransplantation to expand the realm of minimally invasive, nephron sparing surgery to the most complex renal tumors. In our cohort undergoing renal surgery 2 patients had a solitary kidney with renal tumors not considered amenable to in situ partial nephrectomy. After transperitoneal laparoscopic nephrectomy ex vivo tumor excision and renorrhaphy were performed. The kidney was transplanted to the ipsilateral iliac vessels through the Gibson extraction incision. Indications for surgery were high grade urothelial carcinoma within a caliceal diverticulum and a central 5 cm renal cell carcinoma. Mean nephrectomy, cold ischemic and transplantation times were 4.5, 2 and 3.7 hours, respectively. No intraoperative or postoperative complications were noted. Hospitalization was 12 and 6 days, respectively. At 20 and 12 months of followup each patient remained off dialysis without evidence of recurrence. Despite experience with conventional nephron sparing surgery some cases may be more appropriate for ex vivo excision and rec...Continue Reading

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Citations

Mar 31, 2005·Journal of Endourology
Nov 16, 2007·The Journal of Urology·Michael L EisenbergMarshall L Stoller
Oct 19, 2013·International Journal of Urology : Official Journal of the Japanese Urological Association·David MacariJ Stuart Wolf
Mar 25, 2015·The Journal of Urology·Geraldine TranMarshall L Stoller
Aug 12, 2005·Current Opinion in Urology·Sangtae Park, Maxwell V Meng
Oct 4, 2019·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Anthony P TranAdel Bozorgzadeh

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