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Artículo Tomo 71, Número. 2, Marzo 2018

Archivos Españoles de Urología

Laparoscopic partial nephrectomy using the Simon clamp: our experience in 18 cases.

Authors: Gonzalo Vitagliano, Leandro Blas, Maximiliano Ringa, Nicolás Villasante, Hernando Ríos - Pita y Carlos Alberto Ameri.

Arch. Esp. Urol. 2018; 71 (2): 198-203

Vol. 71, Number. 2, March 2018

OBJECTIVE: Kidney tumors represent 2-3% of adult tumors. Partial nephrectomy is the standard of care for the treatment of localized tumors. Minimizing ischemia time is critical for postoperative renal function. The aim of this paper is to present our experience in laparoscopic partial nephrectomy with selective renal parenchymal compression using the Simon clamp.

METHODS: We analyzed the record of patients that underwent surgery for renal tumors between January 2011 and June 2016 at our institution. Cases treated conwith this technique were selected. Demographic variables, operative, and postoperative outcomes were analyzed.

RESULTS: 323 nephrectomies were performed and 18 cases treated with this technique were analyzed. Average age was 56.27 years (34-75) with 10 female cases. BMI was 25.01 kg/m2 (21.2-34.3). 17 cases were lower pole and one upper pole with 11 right and 7 left. Average surgical time was 83.25 minutes (43- 120); renal ischemia time was 21.36 minutes (12-40) with an estimated blood loss of 91 ml (0-400). Average tumor diameter was 2.6 cm (1.8 to 5.3). Glomerular filtration rate preoperative and immediate postoperative was 83 ml/min and 87 ml/min (p=0.42) respectively. Average length of stay was 2.75 days (1-7). All cases had negative margins. With a mean follow up of 23.1 months (1-58) no recurrences were observed.

CONCLUSIONS: Laparoscopic partial nephrectomy using the Simon clamp for vascular control is a feasible technique for selected cases with polar exophytic tumors. Immediate postoperative glomerular filtration rate showed no significant changes and oncological control in our experience was satisfactory.

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