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Urology. 2016 Jun;92:44-50. doi: 10.1016/j.urology.2016.02.048. Epub 2016 Mar 8.

Renal and Adrenal Minilaparoscopy: A Prospective Multicentric Study.

Author information

1
Department of Urology, Fundació Puigvert, Universidad Autonoma de Barcelona, Barcelona, Spain. Electronic address: albbred@hotmail.com.
2
Department of Urology, Fundació Puigvert, Universidad Autonoma de Barcelona, Barcelona, Spain.
3
Department of Urology, Hospital Puerta del Mar, Cádiz, Spain.
4
Department of Urology, Hospital Rio Hortega, Valladolid, Spain.
5
Department of Urology, Hospital General de Vic, Barcelona, Spain.
6
Department of Urology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
7
Department of Urology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.

Abstract

OBJECTIVE:

To investigate the role of contemporary minilaparoscopy (ML; 3 mm instruments and laparoscope) and to identify predictive factors for complications in a prospective multicenter series for renal and adrenal surgeries.

MATERIALS AND METHODS:

From July 2013 to December 2014, 110 patients from 6 laparoscopic Spanish centers were enrolled. A common database was used and data were collected in a prospective manner. Standard approach was defined as 3 to 4 3-mm trocars with a 3-mm laparoscope and 3-mm instruments (Karl Storz, Tuttlingen, Germany). Descriptive variables were analyzed and statistical analysis was performed for predictive factors for complications.

RESULTS:

Patient mean age was 57.8 ± 14.6 years, with an average body mass index of 25.3 ± 3.6 kg/m(2). Median American Society of Anesthesiologists score was II and 32% (n = 35) of the patients had a previous surgery. A total of 59 nephrectomies, 20 partial nephrectomies, 9 nephroureterectomies, 13 pyeloplasties, 3 pyelolithotomies, and 6 adrenalectomies were performed. Overall operative time was 180 ± 64 minutes. There were 12 clampless partials and 8 with a mean warm ischemia time of 14 ± 7 min. There were 5% of intraoperative and 8% of postoperative complications (Clavien II-IV). Mean hospital stay was 5 ± 2.3 days, with optimal pain and cosmetic control.

CONCLUSION:

To our knowledge, this is one of the largest prospective series of ML for renal and adrenal surgeries. Despite a mean operative time possibly longer than in standard laparoscopy, clinical and safety outcomes are not compromised. Furthermore, ML results in excellent pain control and cosmetic outcomes.

PMID:
26968490
DOI:
10.1016/j.urology.2016.02.048
[Indexed for MEDLINE]

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