[27] Safety of pre-intended en bloc renal pedicle control for laparoscopic nephrectomy

Objective: To evaluate preoperatively intended en bloc renal pedicle control for laparoscopic nephrectomy in our hospital, as the safety and efficacy of en bloc renal pedicle control has been approved for laparoscopic nephrectomy but some authors do not advocate the generalised use of it. Methods: W...

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Autores principales:	Tarek Al Zahrani, Mutlaq Alotaibi, Hossam S El-Tholoth, Mohamed AlJaafar, Ibrahim Eid, Ali Obied, Ahmed Al Zahrani
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2018
Materias:	Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/82e79f27ada44b62b6688111d122addb
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spelling	oai:doaj.org-article:82e79f27ada44b62b6688111d122addb2021-12-02T12:36:25Z[27] Safety of pre-intended en bloc renal pedicle control for laparoscopic nephrectomy2090-598X10.1016/j.aju.2018.10.074https://doaj.org/article/82e79f27ada44b62b6688111d122addb2018-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X18301682https://doaj.org/toc/2090-598XObjective: To evaluate preoperatively intended en bloc renal pedicle control for laparoscopic nephrectomy in our hospital, as the safety and efficacy of en bloc renal pedicle control has been approved for laparoscopic nephrectomy but some authors do not advocate the generalised use of it. Methods: We reviewed all laparoscopic nephrectomies that were carried out by two laparoscopic surgeons (from January 2015 until April 2017) who had a preoperative intention of en bloc renal pedicle control. By creating a window at the lower pole and another window at upper pole then using the Covidien Endo-GIA™ (45,60 mm vascular reload) to control the pedicle. We analysed patients’ demographic data, nephrectomy indication, intraoperative findings, and intra- and postoperative complications. Patients were followed-up with blood pressure measurements and for the presence or absence of any signs of hyperdynamic circulation. The analysis of data was done using SPSS® version 20 (SPSS Inc., IBM Corp., Armonk, NY, USA). Results: We found 38 laparoscopic nephrectomies done for patients with mean (range) age 55.7 (18–94) years and mean (range) body mass index of 29.2 (17–41) kg/m2. The indications for nephrectomy were variable: 22 patients (57.9%) for non-functioning kidney, 14 (36.8%) for renal tumours and two (5.2%) for ureteric tumours. There were 23 left nephrectomies and 15 right nephrectomies performed laparoscopically. There were no conversions to open technique and no intraoperative complications. There was an average blood loss of 75 mL and the mean (range) total laparoscopic time was 85 (45–125) min. All cases had no significant postoperative complications, apart from one who developed a postoperative collection and pleural effusion that required a chest tube and drainage. During the follow-up, none of the patients developed signs of an arteriovenous fistula. Conclusion: Pre-intended en bloc renal pedicle control during laparoscopic nephrectomies is safe using the Endo-GIA vascular stapler without significant complications.Tarek Al ZahraniMutlaq AlotaibiHossam S El-TholothMohamed AlJaafarIbrahim EidAli ObiedAhmed Al ZahraniTaylor & Francis GrouparticleDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 16, Iss , Pp S13-S14 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Diseases of the genitourinary system. Urology RC870-923 Tarek Al Zahrani Mutlaq Alotaibi Hossam S El-Tholoth Mohamed AlJaafar Ibrahim Eid Ali Obied Ahmed Al Zahrani [27] Safety of pre-intended en bloc renal pedicle control for laparoscopic nephrectomy
description	Objective: To evaluate preoperatively intended en bloc renal pedicle control for laparoscopic nephrectomy in our hospital, as the safety and efficacy of en bloc renal pedicle control has been approved for laparoscopic nephrectomy but some authors do not advocate the generalised use of it. Methods: We reviewed all laparoscopic nephrectomies that were carried out by two laparoscopic surgeons (from January 2015 until April 2017) who had a preoperative intention of en bloc renal pedicle control. By creating a window at the lower pole and another window at upper pole then using the Covidien Endo-GIA™ (45,60 mm vascular reload) to control the pedicle. We analysed patients’ demographic data, nephrectomy indication, intraoperative findings, and intra- and postoperative complications. Patients were followed-up with blood pressure measurements and for the presence or absence of any signs of hyperdynamic circulation. The analysis of data was done using SPSS® version 20 (SPSS Inc., IBM Corp., Armonk, NY, USA). Results: We found 38 laparoscopic nephrectomies done for patients with mean (range) age 55.7 (18–94) years and mean (range) body mass index of 29.2 (17–41) kg/m2. The indications for nephrectomy were variable: 22 patients (57.9%) for non-functioning kidney, 14 (36.8%) for renal tumours and two (5.2%) for ureteric tumours. There were 23 left nephrectomies and 15 right nephrectomies performed laparoscopically. There were no conversions to open technique and no intraoperative complications. There was an average blood loss of 75 mL and the mean (range) total laparoscopic time was 85 (45–125) min. All cases had no significant postoperative complications, apart from one who developed a postoperative collection and pleural effusion that required a chest tube and drainage. During the follow-up, none of the patients developed signs of an arteriovenous fistula. Conclusion: Pre-intended en bloc renal pedicle control during laparoscopic nephrectomies is safe using the Endo-GIA vascular stapler without significant complications.
format	article
author	Tarek Al Zahrani Mutlaq Alotaibi Hossam S El-Tholoth Mohamed AlJaafar Ibrahim Eid Ali Obied Ahmed Al Zahrani
author_facet	Tarek Al Zahrani Mutlaq Alotaibi Hossam S El-Tholoth Mohamed AlJaafar Ibrahim Eid Ali Obied Ahmed Al Zahrani
author_sort	Tarek Al Zahrani
title	[27] Safety of pre-intended en bloc renal pedicle control for laparoscopic nephrectomy
title_short	[27] Safety of pre-intended en bloc renal pedicle control for laparoscopic nephrectomy
title_full	[27] Safety of pre-intended en bloc renal pedicle control for laparoscopic nephrectomy
title_fullStr	[27] Safety of pre-intended en bloc renal pedicle control for laparoscopic nephrectomy
title_full_unstemmed	[27] Safety of pre-intended en bloc renal pedicle control for laparoscopic nephrectomy
title_sort	[27] safety of pre-intended en bloc renal pedicle control for laparoscopic nephrectomy
publisher	Taylor & Francis Group
publishDate	2018
url	https://doaj.org/article/82e79f27ada44b62b6688111d122addb
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[27] Safety of pre-intended en bloc renal pedicle control for laparoscopic nephrectomy

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