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Laparoscopic Nephrectomy: Assessment of Morcellation versus Intact Specimen Extraction on Postoperative Status

Authors
 FERNANDO HERNANDEZ  ;  KOON H. RHA  ;  THOMAS W. JARRETT  ;  LOUIS R. KAVOUSSI  ;  THERESA Y. CHAN  ;  NICHOLAS KLICOS  ;  FERNANDO J. KIM  ;  PETER A. PINTO 
Citation
 JOURNAL OF UROLOGY, Vol.170(2Pt.1) : 412-415, 2003 
Journal Title
 JOURNAL OF UROLOGY 
ISSN
 0022-5347 
Issue Date
2003
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Laparoscopy/adverse effects ; Laparoscopy/methods* ; Male ; Middle Aged ; Nephrectomy/adverse effects ; Nephrectomy/methods* ; Prospective Studies
Keywords
kidney ; laparoscopy ; nephrectomy ; specimen handling
Abstract
PURPOSE: We compared pathological evaluation and postoperative recovery in patients undergoing transperitoneal laparoscopic nephrectomy at our institution with morcellated vs intact specimen extraction. MATERIALS AND METHODS: A prospective evaluation of 57 consecutive patients undergoing radical and simple transperitoneal laparoscopic nephrectomy was reviewed. One patient was excluded from study due to transitional cell carcinoma, which was detected intraoperatively. The 33 morcellated specimens were extracted at the umbilical port and the 23 intact specimens were extracted through a midline infraumbilical incision. Data were obtained on narcotic requirements, hospital stay, complications, estimated blood loss, mass size based on preoperative imaging, specimen weight and extraction incision length. RESULTS: Mean incision length in the morcellated and intact specimen removal groups was 1.2 and 7.1 cm, respectively (p <0.001). No significant differences in pain or recovery were noted between the 2 groups. Two cases of microscopic invasion of the perinephric adipose tissue in the intact specimen group were up staged from clinical T1 to pT3a disease. No change in patient treatment was made based on this information. CONCLUSIONS: We did not find a significant difference in surgical time, pain or hospital stay. Only incision length was statistically significant. Postoperative recovery appeared to be similar in these 2 groups. With modern imaging modalities information on pathological stage did not alter patient treatment.
Full Text
http://www.sciencedirect.com/science/article/pii/S0022534705633393
DOI
10.1097/01.ju.0000076667.70020.82
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/113562
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