Retroperitoneal laparoscopic nephropexy: a report of 28 cases
Journal Title: Di-er Junyi Daxue Xuebao - Year 2007, Vol 28, Issue 10
Abstract
Objective: To discuss the procedure and clinical effect of retroperitoneal laparoscopic nephropexy (RLN).Methods: From August 2001 to June 2006, RLN was performed on 28 female patients aged 2645 years old (mean, 34±2.5) with symptomatic nephroptosis, including 15 with the right kidney, 12 with the left, and 1 with both. The preoperative complaint of patients included subjective symptoms (constant and recurring pain in 28 patients) and objective symptoms (upper urinary infections in 16, hematuria in 12, and upper tract obstruction in 12). One patient underwent nephropexy via the transperitoneal approach and the others underwent nephropexy via the retroperitoneal approach. A retroperitoneoscopic procedure was performed after positioning the patients in the flank position. Digital preparation of the retroperitoneal space was made and standardized trocar was placed. The key step of the surgery was complete exposure of the kidney within Gerota’ fascia, which was aimed to separate the potential adhesions between the colon and kidney or between the inferior blood vessels of the kidney. Nephropexy was performed between the fibrous capsule at the lower pole of the kidney and the dissected psoas muscle, using three sutures placed by intracorporeal technique or the percutaneous needle both for introduction and removal of the suture; the sutures were separately tied over the sacrospinalis fascia. Results: The mean operative time was (125±9) min (ranging 115240 min); the mean postoperative hospital stay was (9±1.2) days, largely owing to the required 512 days’ bed rest. During a mean followup of (24±4.2) months(ranging 3 to 70 months), 3 patients had paresthesia, 5 had constant and recurrent ache, 20 were completely free of pain, and 4 had microhematuria. One patient had further episodes of pyelonephritis and upper tract obstruction after operation. Intravenous pyelogram(IVP) revealed that the ptosis incorporated into more than one vertebral body in 2 patients. Postoperative renal function test showed an improvement in renal function. Conclusion: RLN is miniinvasive and has less complication. The procedure should be considered as one of the optimal therapy for nephroptosis.
Authors and Affiliations
Jun-hua ZHENG, Bo PENG, Dan-feng XU, Yi GAO
Keywords
Related Articles
- EP ID EP83988
- DOI -
- Views 123
- Downloads 0
外源性血管紧张素Ⅱ在体灌注对大鼠肺泡屏障的损伤作用及机制
目的:观察外源性血管紧张素(Ang)Ⅱ灌注大鼠气道对肺上皮屏障的损伤作用,并探讨其可能的损伤机制。方法:Wistar大鼠随机分为5组:PBS对照组、Ang 6、20 h组、Ang+zVAD-fmk组、Ang+氯沙坦组(n=10),各组大鼠分别经气管灌注PBS、Ang(10 μmol/L)...
Construction of PSAspecific dendritic cell vaccine and its in vitro immune activity
Objective:To construct of PSAspecific dendritic cell (DC) vaccine and to observe its in vitro antitumour activity, so as to pave a way for future study. Methods: Bone marrow precursors were isolated and bone marrow der...
HPLC法同时测定中药丹参中水溶性和脂溶性成分的含量
目的:建立同时测定丹参中2种水溶性成分和2种脂溶性成分的方法。方法:HPLC-DAD法,采用Agilent Zorbax TC C18柱(4.6 mm×250 mm,5 μm),以甲醇2%醋酸为流动相进行梯度洗脱:0～15 min,30% B～40% B; 15～20 min,40% B～60% B; 20～25 min,60%...
Explant combined with trypsin-digestion for culture of endothelial cells from infantile hemangiomas
Objective:To explore a novel method for cultivation of the endothelial cells(EC) from infantile hemangiomas(IH) in vitro and observe the biological character of cultured endothelial cells.Methods:Fresh operative specimen...
Construction and identification of recombinant adenovirus containing wild-type human PKGⅠα gene
Objective:To clone human PKGⅠα gene and construct a recombinant adenovirus vector containing wild-type PKGⅠα.Methods: RT-PCR was used to amplify the full-length PKGⅠα gene from human pulmonary arterial smooth muscle.Afte...