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Complex Arteries No Obstacle to Laparoscopic Nephrectomy

Surgery should be preceded by 3-D computed tomography to minimize injury

THURSDAY, March 29 (HealthDay News) -- Patients with renal tumors who have kidneys with complex vasculature can still be safely treated laparoscopically, researchers report in the March issue of Urology.

Inderbir S. Gill, M.D., of the Cleveland Clinic Foundation in Ohio, and colleagues performed laparoscopic partial nephrectomy on 333 patients, including 60 with multiple renal arteries and 273 with single renal arteries. Prior to surgery, all patients underwent three-dimensional computed tomography to accurately identify tumor and renal vascular anatomy.

The tumors of both groups of patients were of similar size, as were the method of vascular control, tumor parenchymal extension depth and number of pelvicaliceal repairs required during surgery. There were also few differences between the two groups in terms of warm ischemic time, operative time, blood loss and late complications.

"The authors should…be congratulated on exploring another interesting component of their robust experience with laparoscopic partial nephrectomy," according to an editorial by Jaime Landman, M.D., of the Columbia-Presbyterian Medical Center in New York City. "The association of complex renal vascular anatomy and laparoscopic partial nephrectomy will become an increasingly salient issue in urology because of the continued increase in the number of small cortical renal neoplasms that are identified and the growing dissemination and application of laparoscopic partial nephrectomy."

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