Laparoscopic transperitoneal radical nephrectomy for renal masses with level I and II thrombus

Abstract

Background: We aimed to report surgical and oncological outcomes of renal cell carcinoma (RCC) patients with level I and II thrombus treated with laparoscopic transperitoneal radical nephrectomy. Patients and Methods: Medical records of 13 patients were reviewed retrospectively in a single center between 2005 and 2017. Hem-o-lok((R)) clips were used to secure renal artery and renal vein, excluding 2 patients with an attached thrombus on the right side. Results: Seven male and 6 female patients were treated laparoscopically, and conversion to open surgery was not required in any case. The mean age was 61.67.8 years (range 45 to 75 years) and the mean body mass index was 27 +/- 4.6kg/m(2) (range 18.8 to 34.5kg/m(2)). Median tumor size was 9.5x7.3cm (range 5 to 14cm) and 5 patients who had preoperative metastases underwent cytoreductive nephrectomy. The mean operative time was 137.6 +/- 45.8 minutes (range 60 to 200 minutes) and blood loss was 105 +/- 34.9mL (range 50 to 150mL). The mean hospital stay was 4.4 +/- 3.9 days (range 1 to 15 days). Splenic capsular injury occurred in 1 patient and the vena cava was injured in another. Three patients needed blood transfusions. The mean follow-up period was 25 months (range 12 to 86 months). Conclusion: Laparoscopic transperitoneal radical nephrectomy can be reliable option for surgical management of RCC with level I and II thrombus in experienced centers.