Sinan ÇELEN, Yusuf ÖZLÜLERDEN, Aykut BAŞER, Salih BÜTÜN

Transperitoneal laparoskopik radikal nefrektomi uygulanan büyük ve küçük renal kitlelerin sonuçlarının karşılaştırılması

AMAÇLAR Laparoskopik nefrektomi (LRN) uygulanan 8 cm veya daha büyük tümörlü RCC'nin perioperatif sonuçlarını sunmak istiyoruz. GEREÇ VE YÖNTEM Hastanemizde 2018-2020 yılları arasında tek bir cerrah tarafından LRN uygulanan 35 hasta gözden geçirildi. Kurumsal inceleme kurulu onayından sonra, patoloji raporunun tümör büyüklüğüne göre, hastalar küçük boyutlu kitleler (tümör boyutu <8 cm) ve büyük boyutlu kitleler (tümör boyutu ≥8 cm) olarak hastalar 2 gruba ayrıldı. Çalışmaya dahil edilen hastalar demografik özellikler, preoperatif tanı, cerrahi ve yatış süresi, cerrahi öncesi ve sonrası komplikasyonlar ve postoperatif açık cerrahi gereksinimi açısından değerlendirildi. BULGULAR Küçük böbrek kanseri grubu (grup 1) ve büyük böbrek kanseri grubu (grup 2) sırasıyla 19 ve 16 hastadan oluşmaktaydı. İki grup yaş, vücut kitle indeksi ve ortalama tümör büyüklüğü açısından karşılaştırıldı (sırasıyla 5,9 ± 1,4; 9,73 ± 2,17). Hastalar arasında yaş ve tümör boyutu açısından anlamlı farklılık yoktu. Grup 1 hastalarında anlamlı olarak daha az kan kaybı (sırasıyla, 80,7 ± 56,57; 126,87 ± 66,3; p = 0,002) ve daha kısa ameliyat süresi (sırasıyla 87,36 ± 15,21; 103,12 ± 11,38 dakika, p = 0,001) izlendi. SONUÇLAR Verilerimiz transperitoneal laparoskopik nefrektomi ile daha büyük tümörlerin güvenle rezeke edilebildiğini göstermiştir. Laparoskopik deneyime sahip ürologlar LRN endikasyonlarını genişletmeyi düşünmelidir.

Anahtar Kelimeler:

laparoskopi, radikal nefrektomi, böbrek kanseri

Comparison of the results of large and small renal masses under transperitoneal laparoscopic radical nephrectomy

OBJECTIVES We want to represent perioperative results of RCC with 8 cm or greater tumor size underwent laparoscopic nephrectomy (LRN) METHODS In our institution, 35 patients who underwent LRN by a single surgeon in the period between 2018 and 2020, were reviewed. After institutional review board approval, patients were divided into 2 groups, according to tumor size of pathology report, as small renal cancer with small size (tumor size <8 cm) and renal cancer with large size (tumor size ≥8 cm). Included patients were assessed in terms of demographic characteristics, preoperative diagnosis, duration of surgery and hospitalization, complications before and after surgery, and postoperative requirement for open surgery. RESULTS Small renal masses (group 1) and large renal masses (group 2) consisted of 19 and 16 patients, respectively. The 2 groups were compared in terms of age, body mass index and mean tumor size (5,9±1,4; 9,73±2,17, respectively). There was no significant difference with respect to age and tumor size between patients. Group 1 patients experienced significantly less blood loss (respectively, 80,7±56,57; 126,87±66,3; p=0,002), shorter operation time (respectively, 87,36±15,21; 103,12±11,38 minutes, p=0,001). CONCLUSIONS Our data showed that larger tumors can safely be resected with transperitoneal laparoscopic nephrectomy. Urologists with laparoscopic experience should consider expanding their indication for LRN.

Keywords:

laparoscopy, radical nephrectomy, renal cancer,

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