COMPLICATIONS IN RENAL CARCINOMA MANAGEMENT

Česká verzia

Authors: A. Čermák
Authors place of work: Urologická klinika FN Brno
Published in the journal: Urol List 2010; 8(1): 64-70

Summary

The improvement of individual techniques enables to define evidence demonstrating when and how is laparoscopy effective in surgical treatment of renal carcinoma and to show its benefits and drawbacks. LRN is currently considered as the standard method in renal carcinoma management. The improvement of techniques led to oncological results comparable with open techniques [1], shortening of hospitalization, improvement of cosmetic results and blood loss decrease [2,3]. Laparoscopic partial nephrectomy (LPN) in small tumors (< 4 cm) has shown similar results as in open partial nephrectomy (OPN) [4]. Gradual implementation of laparoscopic techniques in surgical management enhanced the focus on the issues of complication incidence.

This article reviews the occurrence of intra-operative, short-term and long-term post-operative complications in laparoscopic management of renal diseases. It also deals with the prevention and management of serious complications in LRN and LPN.

Key words:
renal carcinoma, laparoscopy, radical nephrectomy, partial nephrectomy, cryoablation, radiofrequency ablation, complications, prevention

Zdroje

1. Clayman RV, Kavoussi LR, Soper NJ et al. Laparoscopic nephrectomy. N Engl J Med 1991; 324(19): 1370–1371.

2. Eskicorapci SY, Teber D, Schulze M et al. Laparoscopic radical nephrectomy: the new gold standard surgical treatment for localized renal cell carcinoma. ScientificWorldJournal 2007; 7: 825–836.

3. Permpongkosol S, Chan DY, Link RE et al. Longterm survival analysis after laparoscopic radical nephrectomy. J Urol 2005; 174: 1222–1225.

4. Russo P. Is laparoscopic partial nephrectomy as effective as open partial nephrectomy in patients with renal cell carcinoma? Nat Clin Pract Urol 2008; 5(1): 12–13.

5. Schäfer M, Lauper M, Krähenbühl L. Trocar and Cerese needle injuries during laparoscopy. Surg Endosc 2001; 15(3): 275–280.

6. Catarci M, Carlini M, Gentileschi P et al. Major and minor injuries during the creation of pneumoperitoneum. A multicenter study on 12 919 cases. Surg Endosc 2001; 15(6): 566–569.

7. Minervini A, Davenport K, Pefanis G et al. Prospective study comparing the bladeless optical access trocar versus Hasson open trocar for the establishment of pneumoperitoneum in laparoscopic renal procedures. Arch Ital Urol Nadrol 2008; 80(3): 95–98.

8. Steinberg AP, Finelli A, Desai MM et al. Laparoscopic radical nephrectomy for large (greater than 7 cm, T2) renal tumors. J Urol 2004; 172: 2172–2176.

9. Dunn MD, Portis AJ, Shalhav AL et al. Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol 2000; 164(4): 1153–1159.

10. Bishoff JT, Allaf ME, Kirkels W et al. Laparoscopic bowel injury: incidence and clinical presentation. J Urol 1999; 161(3): 887–890.

11. Abdel-MeguidTA, Gommella LG. Prevention andmanagement of complications. In: Smith AD, Badlani GH, Bagley DH, et al. editors. Smith’s Textbook of Endourology. St. Louis, MO: Quality Medical Publishing; 1996: 851–869.

12. Permpongkosol S, Link RE, Su LM et al. Complications of 2775 urological laparoscopic procedures: 1993 to 2005. J Urol 2007; 177(2): 580–585.

13. Mejean A, Vogt B, Quazza JE et al. Mortality and morbidity after nephrectomy for renal cellccarcinoma using a transperitoneal anterior subcostal incision. Eur Urol 1999; 36(4): 298–302.

14. Canby-Hagino ED, Morey AF, Jatoi I et al. Fibrin sealant treatment of splenic injury during open and laparoscopic left radical nephrectomy. J Urol 2000; 164(6): 2004–2005.

15. Varkarakis IM, Allaf ME, Bhayani SB et al. Pancreatic injuries during laparoscopic urologic surgery. Urology 2004; 64(6): 1089–1093.

16. Aron M, Colombo JR jr., Turna B et al. Diaphragmatic repair and/or reconstruction dutiny upper abdominal urological laparoscopy. J Urol 2007; 178(6): 2444–2450.

17. Del Pizzo JJ, Jacobs SC, Bishoff JT et al. Pleural injury during laparoscopic renal surgery: early recognition and management. J Urol 2003; 169(1): 41–44.

18. McDougall E, Clayman RV, Elashry OM. Laparo - scopic radical nephrectomy for renal tumor: the Washington University experience. J Urol 1996; 155(4): 1180–1185.

19. Buse S, Gilfrich C, Pfitzenmaier J et al. En bloc stapler ligation of the renal vascular pedicle during laparoscopic nephrectomy. BJU Int 2008; 101(7): 878–882.

20. Kouba E, Smith AM, Derksen JE et al. Efficacy and safety of en bloc ligation of renal hilum during laparoscopic nephrectomy. Urology 2007; 69(2): 226–229.

21. Chan D, Bishoff JT, Ratner L et al. Endovascular gastrointestinal stapler device malfunction during laparoscopic nephrectomy: early recognition and management. J Urol 2000; 164(2): 319–321.

22. Hsi RS, Saint-Elie DT, Zimmerman GJ et al. Mechanisms of hemostatic failure during laparoscopic nephrectomy: review of Food and Drug Administration database. Urology 2007; 70(5): 888–892.

23. Ponsky L, Cherullo E, Moinzadeh A et al. The Hemolok clip is safe for laparoscopic nephrectomy: a multi-institutional review. Urology 2008; 71(4): 593–596.

24. Breda A, Veale J, Liao J et al. Complications of laparoscopic living donor nephrectomy and their management: the UCLA experience. Urology 2007; 69(1): 49–52.

25. Kaouk JH, Gill IS. Laparoscopic radical nephrectomy: morcellate or leave intact? Leave intact. Rev Urol 2002; 4(1): 38–42.

26. Colombo JR jr., Haber GP, Jelovsek JE et al. Complications of laparoscopic surgery for urological cancer: a single institution analysis. J Urol 2007; 178: 786–791.

27. Begg CB, Cramer LD, Hoskins WJ et al. Impact of hospital volume on operativemortality for major cancor surgery. JAMA 1998; 280(20): 1747–1751.

28. Nambirajan T, Jeschke S, Al-Zahrani H et al. Prospective, randomized controlled study: transperitoneal laparoscopic versus retroperitoneoscopic radical nephrectomy. Urology 2004; 64(5): 919–924.

29. Desai MM, Strzempkowski B, Matin SF et al. Prospective randomized comparison of transperitoneal versus retroperitoneal laparoscopic radical nephrectomy. J Urol 2005; 173(1): 38–41.

30. Berglund RK, Gill IS, Babineau D et al. A prospective comparison of transperitoneal and retroperitoneal laparoscopic nephrectomy in the extremely obese patient. BJU Int 2007; 99(4): 871–874.

31. Matin SF, Abreu S, Ramani A et al. Evaluation of age and comorbidity as risk factors after laparoscopic urological surgery. J Urol 2003; 170: 1115–1120.

32. Montgomery JS, Johnston III WK, Wolf JS jr. Wound complications after hand assisted laparoscopic surgery. J Urol 2005; 174(6): 2226–2230.

33. Gill IS, Matin SF, Desai MM et al. Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumors in 200 patients. J Urol 2003; 170(1): 64–68.

34. Porpiglia F, Renard J, BilliaM et al. Is renalwarmischemia over 30 minutes during laparoscopic partial nephrectomy possible?One-year results of a prospective study. Eur Urol 2007; 52(4): 1170–1178.

35. Janetschek G. Laparoscopic partial nephrectomy for RCC: how can we avoid ischemic damage of the renal parenchyma? Eur Urol 2007; 52(5): 1303–1305.

36. Simmons MN, Gill IS. Decreased complications of contemporary laparoscopic partial nephrectomy: use of a standardized reporting system. J Urol 2007; 177(6): 2067–2073.

37. Turna B, Frota R, Kamoi K et al. Risk factor analysis of postoperative complications in laparoscopic par tial nephrectomy. J Urol 2008; 179(4): 1289–1294.

38. Nadu A, Mor Y, Laufer M et al. Laparoscopic partial nephrectomy: single center experience with 140 patients – evolution of the surgical technique and its impact on patient outcomes. J Urol 2007; 178(2): 435–438.

39. Breda A, Stepanian SV, Lam JS et al. Use of haemostatic agents and glues during laparoscopic partial nephrectomy: amulti-institutional survey fromthe United States and Europe of 1347 cases. Eur Urol 2007; 52: 798–803.

40. Celia A, Zeccolini G, Guazzoni G et al. Laparoscopic nephron sparing surgery: amulti-institutional European survey of 592 cases. Arch Ital Urol Androl 2008; 80(3): 85–91.

41. Zorn KC, Gong EM, Orvieto MA et al. Impact of collecting-system repair dutiny laparoscopic partial nephrectomy. J Endourol 2007; 21(3): 315–320.

42. Zimmermann R, Janetschek G. Complications of laparoscopic partial nephrectomy. World J Urol 2008; 26(6): 531–537.

43. Meeks JJ, Zhao LC, Navai N et al. Risk factors and management of urine leaks after partial nephrectomy. J Urol 2008; 180(6): 2375–2378.

44. Gill IS, Kavoussi LR, Lane BR et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol 2007; 178(1): 41–46.

45. Breda A, Stepanian SV, Liao J et al. Positive margins in laparoscopic partial nephrectomy in 855 cases: a multiinstitutional survey from the United States and Europe. J Urol 2007; 178: 47–50.

46. Gill IS, Matin SF, Desai MM et al. Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumors in 200 patients. J Urol 2003; 170(1): 64–68.

47. Porpiglia F, Fiori C, Terrone C et al. Assessment of surgicalmargins in renal cell carcinoma after nephron sparing: a komparative study: laparoscopy vs open surgery. J Urol 2005; 173(4): 1098–1101.

48. Sutherland SE, ResnickMI, Maclennan GT et al. Does the size of the surgicalmargin in partial nephrectomy for renal cell cancer really matter? J Urol 2002; 167(1): 61–64.

49. Yossepowitch O, Thompson RH, Leibovich BC et al. Positive surgical margins at partial nephrectomy: predictors and oncological outcomes. J Urol 2008; 179(6): 2158–2163.

50. Marberger M, Pugh RC, Auvert J et al. Conservation surgery of renal carcinoma: the EIRSS experience. Br J Urol 1981; 53(6): 528–532.

51. Van Poppel H, Bamelis B, Oyen R et al. Partial nephrectomy for renal cell carcinoma can achieve long-term tumor control. J Urol 1998; 160: 674–678.

52. Moll V, Becht E, Ziegler M. Kidney preserving surgery in renal cell tumors: indications, techniques and results in 152 patients. J Urol 1993; 150: 319–323.

53. Campbell SC, Novick AC, Streem SB et al. Complications of nephron sparing surgery for renal tumors. J Urol 1994; 151(5): 1177–1180.

54. Polascik TJ, Pound CR, Meng MV et al. Partial nephrectomy: technique, complications and pathological findings. J Urol 1995; 154(4): 1312–1318.

55. Belldegrun A, Tsui KH, deKernion JB et al. Efficacy of nephron-sparing surgery for renal cell carcinoma: analysis based on the new 1997 tumor-node-metastasis staging system. J Clin Oncol 1999; 17(9): 2868–2875.

56. Patard J-J, Pantuck AJ, Crepel M et al. Morbidity and clinical outcome of nephron-sparing surgery in relation to tumour size and indication. Eur Urol 2007; 52(1): 148–154.

57. Ng CS, Gill IS, Ramani AP et al. Transperitoneal versus retroperitoneal laparoscopic partial nephrectomy: patient selection and perioperative outcomes. J Urol 2005; 174(3): 846–849.

58. Breda A, Lam JS, Riggs S et al. In vivo efficacy of laparoscopic assisted percutaneous renal cryotherapy: evidence based guidelines for the practicing urologist. J Urol 2008; 179(1): 333–337.

59. Stein RJ, Kaouk JH. Renal cryotherapy: a detailed review including a 5-year follow-up. BJU Int 2007; 99: 1265–1270.

60. Gill IS, Remer EM, Hasan WA et al. Renal cryoablation: outcome at 3 years. J Urol 2005; 173(6): 1903–1907.

61. Cestari A, Guazzoni G, Buffi NM et al. Laparo scopic cryoablation of small renal masses: technique and results after 6-year experience. Eur Urol Suppl 2007; 6: 646–652.

62. Davol PE, Fulmer BR, Rukstalis DB. Long-term results of cryoablation for renal cancer and complex renal masses. Urology 2006; 68: 2–6.

63. Polascik TJ, Nosnik I, Mouraviev V. Laparoscopic renal cryoablation for tumors less than 3.5 cm. J Endourol 2006; 20: A177.

64. Johnson DB, Solomon SB, Su LM et al. Defining the complications of cryoablation and radio frequency ablation of small renal tumors: a multi-institutional review. J Urol 2004; 172(3): 874–787.

65. Hegarty NJ, Gill IS, Desai MM et al. Probe-ablative nephron-sparing surgery: cryoablation versus radiofrequency ablation. Urology 2006; 68: 7–13.

66. Goel RK, Kaouk JH. Single port access renal cryoablation (SPARC): a new approach. Eur Urol 2008; 53(6): 1204–1209.