Mehmet Salih BOĞA, Murat SAVAŞ, Mahmut Ekrem İSLAMOĞLU, Mehmet Giray SÖNMEZ, Kayhan YILMAZ, Mahmut Taha ÖLÇÜCÜ, Kaan KIRAMIK, Çağatay ÖZSOY, Mutlu ATEŞ

T1a/T1b Evre Renal Tümörlerde Laparoskopik Parsiyel Nefrektomi: Biz Neredeyiz?

Amaç: T1a / T1b evre böbrek tümörlerinde laparoskopik parsiyel nefrektomi yapılan hastalara ait (LPN) demografikverileri, perioperatif ve postoperatif sonuçları rapor etmeyi amaçladık.Gereç ve Yöntem: Retrospektif olarak Mayıs 2015 - Ekim 2018 arasında normal kontralateral böbreği olan ve LPNyapılan 60 hasta değerlendirildi. Demografik, perioperatif ve postoperatif sonuçlar literatür ile değerlendirildi vetartışıldı.Bulgular: Çalışmaya 42 hasta dahil edildi. Ortalama yaş, tümör boyutu ve RENAL skorları sırasıyla 60.52 (± 10.51),3.58 (± 1.55) cm ve 6.548 (± 1.17) idi. Sıcak iskemi süresi 26,88 (± 6,27) dakika idi. Ortalama ameliyat süresi, tahminikan kaybı, hastanede kalış süresi, 162.26 (± 38.97) dk, 166.79 (± 98.32) mL ve 3.45 (± 0.89) gündü. Preoperatif vepostoperatif tahmini glomerüler filtrasyon hızı (eGFR) sırasıyla 76.83 (± 18.36) ve 71.93 (± 20,12) mL / dak / 1.73 m2idi. eGFR azalması ameliyat sonrası 3 ayda 4.9 (% 6.38) mL / dak / 1.73 m2 idi. Postoperatif komplikasyon oranı, cerrahisınır durumu ve eGFR azalması literatür ile benzer olarak bulundu. Ortalama takip süresi 21.02 (± 13.26) aydı.Sonuç: Her ne kadar LPN uzun bir öğrenme eğrisine sahip olsa da, seçilmiş renal tümör vakalarında mükemmelonkolojik ve fonksiyonel sonuçlarla kabul edilebilir komplikasyon oranları ile uygulanabilen güvenli bir PN yöntemidir.

Anahtar Kelimeler:

laparoskopik parsiyel nefrektomi, minimal invaziv cerrahi, böbrek tümörü

Laparoscopic Partial Nephrectomy in T1a/T1b Stage Renal Tumors: Where We Are?

Aim: To report the demografics, operative and postoperative outcomes of laparoscopic partial nephrectomy (LPN)in T1a/T1b stage renal tumors.Matherials and Methods: In total of 60 patients were evaluated, retrospectively who underwent LPN with anormal contralateral kidney, between May 2015 and October 2018. Demographics, perioperative and postoperativeoutcomes were evaluated and discussed with the literature.Result: 42 patients were included in the study. The mean age, tumor size and RENAL scores were 60.52 (± 10.51) years,3.58 (± 1.55) cm and 6.548 (± 1.17), respectively. The duration of warm ischemia time was 26,88 (± 6,27) minutes. Themean operative time, estimated blood loss, length of hospital stay time were 162.26 (± 38.97) min, 166.79 (± 98.32)mL and 3.45 (± 0.89) days, respectively. Preoperative and postoperative estimated glomerular filtration rate (eGFR)were 76.83 (± 18.36) and 71.93 (± 20,12) mL/min/1.73 m2, respectively. eGFR decrease was 4.9 (6.38%) mL/min/1.73m2 at the 3 months postoperative. The rate of postoperative complications, surgical margin status and eGFR decreasewere similer to literature. The mean follow-up time was 21.02 (± 13.26) months.Conclusion: Although LPN has long learning curve, it is a safe PN method that can be applied in selected renaltumor cases with excellent oncological and functional results with acceptable complication rates.

Keywords:

laparoscopic partial nephrectomy, minimally invasive surgery, renal tumor,

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