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Laparoscopic Renal Surgery After Spontaneous Retroperitoneal Hemorrhage

Authors
 FERNANDO HERNANDEZ  ;  ALBERT M. ONG  ;  LOUIS R. KAVOUSSI  ;  PETER A. PINTO  ;  KOON H. RHA 
Citation
 JOURNAL OF UROLOGY, Vol.170(3) : 749-751, 2003 
Journal Title
 JOURNAL OF UROLOGY 
ISSN
 0022-5347 
Issue Date
2003
MeSH
Adult ; Aged ; Angiomyolipoma/complications* ; Female ; Hemorrhage/diagnosis ; Hemorrhage/etiology* ; Humans ; Kidney Diseases/diagnosis ; Kidney Diseases/etiology* ; Kidney Neoplasms/complications* ; Male ; Middle Aged ; Nephrectomy ; Retroperitoneal Space ; Retrospective Studies
Keywords
laparoscopy ; hemorrhage ; kidney ; rupture ; nephrectomy
Abstract
PURPOSE: We assessed the role of laparoscopic management in patients following spontaneous retroperitoneal hemorrhage from a renal tumor. MATERIALS AND METHODS: A retrospective chart review revealed 4 patients with spontaneous retroperitoneal hemorrhage treated at our institution in the last 2 years. After conservative management elsewhere patients were referred for definitive therapy. Patient characteristics and tumor size were examined and correlated with ease of surgical dissection and surgical outcome. No patient had any history of trauma. Computerized tomography was used to identify the initial extent of hemorrhage in all patients. RESULTS: All patients underwent successful laparoscopic exploration without the need for open conversion. Three patients underwent radical nephrectomy and 1 underwent laparoscopic partial nephrectomy. Renal hemorrhage extending outside of the renal capsule was associated with significantly more adhesions than renal hemorrhage confined to the renal capsule. Mean patient age was 56 years (range 36 to 70). Mean retroperitoneal tumor size was 5.3 cm (range 2.5 to 10). Three renal hematomas were extracapsular and 1 was subcapsular. Mean operative time was 182.3 minutes (range 59 to 235). Average estimated blood loss was 800 cc (range 150 to 2,100). CONCLUSIONS: Nontraumatic retroperitoneal hemorrhage of renal origin may be managed using traditional laparoscopic techniques with results similar to those achieved with open renal exploration. These cases may prove technically challenging due to fibrosis and associated tissue plane loss.
Full Text
http://www.sciencedirect.com/science/article/pii/S0022534705632223
DOI
10.1097/01.ju.0000080571.31196.d0
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/22282913/113694
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