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C C Abbou

Publications and source records attributed to C C Abbou.

At least 73 records · Page 4Linked to original sources
PubMed2000

Laparoscopic radical prostatectomy: preliminary results.

BACKGROUND: Retropubic and perineal radical prostatectomy are used for curative treatment of localized prostate cancer. More complex urological procedures are now being done with laparoscopy. We present our initial results of transperitoneal laparoscopic radical prostatectomy. MATERIALS AND METHODS: Twenty laparoscopic radical prostatectomies were performed between May 1998 and May 1999. The mean age at the time of surgery was 64.2 years. There were 14 stage T1c, 5 stage T2a and 1 stage T2b tumors. The preoperative PSA was 9. 3 ng/ml (normal <4 ng/ml). The Gleason score for positive specimens in 6 random echo-guided endorectal biopsies was 5.7. Four trocars were used. Insufflation pressure was 15 mmHg. The seminal vesicles were first dissected. The prostate was dissected free from the anterior face of the rectum to the prostate apex. Then the peritoneum was incised to find the apex of the prostate. The puboprostatic ligaments were isolated and cut, and the dorsal vein complex was ligated and cut to expose the urethra. The bladder neck was opened and dissected free from the prostate. The lateral pedicles were coagulated before sectioning the urethra. The radical prostatectomy specimen was left along the sigmoid colon, the bladder neck was reconstructed, and a urethrovesical anastomosis was performed with 6 interrupted sutures. The prostatectomy specimen was removed intact in a sack by enlarging the umbilical trocar port. All the prostatectomy specimens were processed according to the Standford protocol. Prostate weight, tumor weight, the Gleason score, and the tumor status of the capsule, seminal vesicles, lymph nodes and surgical margins were studied. RESULTS: The operating time was 385 min. Two patients were transfused. The mean hospital stay was 7. 8 days. The Foley catheter was removed 10.7 days after the operation. Specimen weight was 61 (28-126) g, the Gleason score was 5.9, and tumor volume was 1.4 ml. There were 18 stage pT2, 1 stage pTa (capsular effraction) and 1 stage pT3b (seminal vesicle invasion) tumors. There were four positive surgical margins (2 at the apex and 2 at the bladder neck). All the patients had a postoperative PSA level <0.1 ng/ml at 1 month. The first patient had urethrovesical anastomotic leakage, and required Foley catheterization for 21 days. There was 1 colostomy for rectal injury and 1 urinoma because of urethrovesical anastomotic leakage that required an open surgical procedure. One month after surgery, 15 (75%) patients were fully continent. Six patients had erections, and 5 stated having sexual intercourse. CONCLUSION: These preliminary results show that radical prostatectomy can be performed laparoscopically. Laparoscopy offered excellent vision of all the anatomical structures of the pelvis, permitting precise dissection. Long-term follow-up and further studies are required to confirm and improve these results.

Aged↗
PubMed2000

Carcinological risks and retroperitoneal laparoscopy.

PURPOSE: To determine the incidence of trocar site spillage, local recurrence, and metastatic disease associated with retroperitoneal laparoscopic tumor resection. METHODS: From 1994 to 1999, 228 retroperitoneal laparoscopic procedures were performed at our institution. Fifty-six procedures (24.6%) were for malignancies and comprised 41 radical nephrectomies and 8 partial nephrectomies for renal tumors, and 7 nephro-ureterectomies for renal pelvis tumors. The pathological stage and the status of surgical margins were noted according to the 1997 TNM classification. Postoperative follow-up data were obtained by means of physical and radiological examinations after 1 and 3 months, and then half-yearly. Trocar site seeding, local recurrence and metastatic disease were recorded. Kaplan-Meier actuarial analysis was used to determine the disease-free survival likelihood. RESULTS: The mean follow-up was 24.9+/-13.85 months. All the patients had tumor-free surgical margins. No laparoscopic trocar site recurrences were identified. For laparoscopic radical nephrectomy: one patient had a local recurrence with hepatic metastasis of a pT(3)G(2) tumor after 9 months and died 19.7 months after the procedure. One patient with a pT(3a)G(3)M+ tumor died 23.1 months after radical nephrectomy without any sign of local recurrence. For laparoscopic nephro-ureterectomy: one patient with a pT(3)G(3) tumor had a local recurrence 12.1 months after the procedure and died 26.6 months after surgery. One patient with a pT(1)G(2) renal pelvis tumor had bone metastasis at 9 months and died 29 months after the procedure. The Kaplan-Meier actuarial disease-free survival rate was 91% at 54 months for radical nephrectomy, 61% at 30 months for nephro-ureterectomy and 100% at 49 months for partial nephrectomy. CONCLUSION: Malignancies of the upper urinary tract can be managed by means of retroperitoneal laparoscopy. Short-term results suggest that this procedure is not associated with an increased risk of portsite or local recurrence, and that disease-free survival is equivalent to that obtained with open surgery.

Adult↗
PubMed2000

Nondissection of pelvic lymph nodes does not influence the results of perineal radical prostatectomy in selected patients.

OBJECTIVES: Retrospective studies have shown that pelvic lymph node dissection can be dispensed with in selected men undergoing radical prostatectomy. We prospectively evaluated the influence of nondissection of pelvic lymph nodes on tumor progression in our first 100 perineal prostatectomies. METHODS: From October 1992 to February 1998, 100 patients underwent radical perineal prostatectomy for localized prostate cancer. Preoperative PSA, the Gleason score of positive biopsies and age at surgery were noted. Forty-three of the 100 patients (group 1) did not undergo pelvic lymph node dissection because their preoperative PSA level was below 10 ng/ml (Hybritech assay, normal value 4 ng/ml) and the Gleason score of their positive biopsies was below 7. These 43 patients were compared with 25 of the 114 patients operated on during the same period by the retropubic approach and who had pelvic node dissection and the same preoperative criteria (PSA <10 ng/ml and a Gleason score of positive biopsies <7; group 2). All prostatectomy specimens were processed according to the Stanford protocol: prostate weight, Gleason score, capsular, seminal vesicle, lymph node and surgical margin status, and tumor volume were studied. Postoperative followup was based on routine serum PSA assays after 1 and 3 months and then half-yearly. Biological progression was defined as PSA level which was detectable postoperatively (>/=0.2 ng/ml). Kaplan-Meier analysis was used to evaluate the likelihood of biochemical recurrence. Results were compared by using Fisher's test, the Mann-Whitney test and the log-rank test. Differences were considered significant when the p value was <0.05. RESULTS: No differences in preoperative characteristics were observed; in groups 1 and 2, mean age was 65.9 and 64.7 years, PSA was 6.7 and 5.11 ng/ml, and the Gleason biopsy score was 5.7 vs. 5.0, respectively. In groups 1 and 2, specimen weight was 44.5 and 54.3 g (p = 0.04), the Gleason score was 6.2 and 5.6, tumor volume was 0.91 and 0.8 ml, 81.4 and 84% of patients were in stage pT2, 13.9 and 12% had extracapsular disease, 4.6 and 0% had seminal vesicle invasion, and 13.9 and 16% had positive surgical margins, respectively. The mean follow-up was 2.74 years (0.27-5.59 years). The actuarial 5-year recurrence-free rate was 78% in group 1 and 80% in group 2 (p>0.05). CONCLUSION: The lack of pelvic lymph node dissection does not influence the intermediate term results of perineal radical prostatectomy in selected patients (preoperative PSA <10 ng/ml and Gleason score for positive biopsies <7).

Aged↗
PubMed2000

Assessment of penile small nerve fiber damage after transurethral resection of the prostate by measurement of penile thermal sensation.

PURPOSE: To determine the occurrence of penile small nerve fiber damage following transurethral resection of the prostate (TURP) for benign prostatic hypertrophy (BPH). MATERIALS AND METHODS: Penile nerve function was evaluated in 18 consecutive patients prior to and one month after TURP for BPH. To test nerve fibers of small diameter, the penile warm and cold sensory thresholds were measured by means of a Peltier-based device, as well as the penile sympathetic skin potentials obtained following electrical stimulation at the wrist. To test nerve fibers of large diameter, the pudendal nerve somatosensory evoked potentials (pSEPs) and the penile vibratory thresholds were recorded. Clinical erectile function was quantified using a standardized questionnaire (erectile dysfunction symptom score, EDSS). Urinary handicap was assessed by the measurement of maximum flow rate (MFR) at uroflowmetry and by a standardized questionnaire (AUA symptom score, AUASS). RESULTS: Penile warm threshold (+7.8 vs +6.3C, p = 0.005), cold threshold (-8.5 vs -5.7C, p = 0.003) and vibratory threshold (9.3 vs 7.9 microm., p = 0.03) were significantly higher after than prior to TURP. The amplitude of pSEPs tended to decrease (1.7 versus 2.3 microV, p = 0.06), whereas the remaining neurophysiological parameters were unchanged. Clinical assessment by EDSS demonstrated a significant postoperative erectile function impairment (20.2 vs 17.5, p = 0.04), whereas mictional function improved (MFR: 19 vs 8.8 ml./s and AUASS: 4.9 versus 15.1, p < 0.0001). CONCLUSIONS: This study highlights the occurrence of penile small nerve fiber damage following TURP and supports the hypothesis of neurogenic damage as the primary cause of post-operative erectile dysfunction.

Aged↗
PubMed2000

[Remote laparoscopic radical prostatectomy carried out with a robot. Report of a case].

Robotics has been commonly employed in numerous industrial fields for several decades. However, the application of this technology to surgery is a recent innovation. It provides new possibilities for facilitating specific surgical tasks, especially in the field of laparoscopy. We report a case of laparoscopic radical prostatectomy completed with the help of a remotely controlled da Vinci robot. This system offered a user friendly surgical platform and enhanced surgical dexterity. Operating time was 420 minutes and the hospital stay was 4 days. The bladder catheter was removed after 3 days. One week later, the patient was fully continent. Pathologic examination showed a pT3a tumor, with negative margins. Robotically assisted laparoscopic radical prostatectomy is feasible. Further developments in this field of technology may have new applications in laparoscopic telesurgery.

Equipment Design↗
PubMed2000

[Nephrectomy in a living donor by retroperitoneal laparoscopy or lomboscopy].

INTRODUCTION: The advantages of laparoscopic live donor nephrectomy are now well documented. This new approach can lower donor morbidity and could stimulate living related organ donation. We described our original operative technique and report our preliminary results. MATERIAL AND METHODS: Since 1998, we have used the retroperitoneal laparoscopy in tree related living donors. Advantages and inconvenient of this new surgical procedure were discussed with each donors and inform consent obtained. The left kidney was harvested in the three cases. RESULTS: The operative time was inferior to 280 minutes, warm ischemia less than five minutes and bleeding less than 150 mL. Patients were discharged between the 2nd and 3rd post-operative days. CONCLUSION: Retroperitoneal laparoscopy is a valuable alternative in transplant centres with skilled laparoscopic surgeons.

Humans↗
PubMed2000

[Postoperative complications following kidney transplantation].

Despite the remarkable development of kidney transplantation techniques, surgical complications are still a very important factor affecting the final outcome of kidney transplantation. After 92 kidney transplantations (22 from cadaver donors and 70 from living donors) performed at Skopje hospital (Macedonia), we observed the following complications: nine (10%) urinary fistula, five (5%) graft ruptures, seven (8%) lymphoceles, two (2%) urinary calculosis, two (2%) intestinal perforations, four (4%) renal artery stenoses, one (1%) renal artery thrombosis, and seven (8%) early complications following surgical incision. Complications were detected by either ultrasonography, intravenous pyelography, percutaneous nephrostomy with anterograde pyelography, computerized tomography, and intravenous digital angiography. They were subsequently treated by application of modern surgical procedures: use of the ureter (termino-terminal or uretero-pyelic anastomosis) for treatment of urinary fistulas; conservative surgery using tissue glue and external compression with polyglactin 910 (Vicryl) mesh for graft ruptures; drainage and application of sclerosants under ultrasound control and intraperitoneal marsupialization for the clinically relevant lymphoceles; transluminal angioplasty with balloon dilatation in case of significant arterial stenosis; extracorporeal shock wave lithotripsy and surgery for urinary calculi. Intestinal perforations and problems relating to parietal tissue were quickly solved using standard surgical techniques. On total, rejection of the graft occurred in four (4%) cases following surgical complications, while one death was encountered due to septic peritonitis. We consider the percentage of surgical complications acceptable, as this work consists of a pioneering effort in this Balkan region.

Adult↗
PubMed2000

[Results of 25 years of kidney transplantation].

Between 1975 and 2000, 1008 renal transplantations were performed in 935 recipients at Henri Mondor hospital. The mean objective of this study is to analyse patient and graft survivals at long term. For kidney transplantations performed respectively before and after 1985, ten years patient survival was 74.3% +/- 0.03 and 85.7% +/- 0.01, p = 0.03 and ten years graft survival was 39.5% +/- 0.04 and 71.9% +/- 0.02 after 1985, p = 0.001. Since 1985, an enhancement in graft actuarial survival still improved (one year survival 86.1% +/- 0.01 versus 90.8% +/- 0.02, three years survival 78.5% +/- 0.02 versus 85.5% +/- 0.02, five years survival 71.7% +/- 0.02 versus 78.8% +/- 0.04, for the years 1985-1994 versus 1995-2000, p < or = 0.05). Immunosuppressive drugs may contribute to results enhancement in kidney transplantation while other non immunologic factors are becoming more predominant.

Adolescent↗
PubMed2000

[Mechanisms of action of BCG: towards a new individualized therapeutic approach?].

A better knowledge of antitumour immunity and the mechanisms allowing the tumour to overcome the host's immune surveillance has led to progress in the understanding of the mechanisms of action of Bacille Calmette-Guérin (BCG), as the local intravesical immune response is intimately related to the interaction of three systems: the host (the patient), the BCG (mycobacteria) and the tumour. This interaction gives rise to a cascade of immunological events, some of which are essential to the protective action of BCG against relapse and tumour progression. The immune response to BCG is currently considered to comprise three phases. First of all, the BCG adheres to the urothelium and is then phagocytosed by antigen-presenting cells. This phase corresponds to early release of so-called inflammatory cytokines (IL1, IL6, IL8). These cytokines could be responsible for certain adverse effects, but could also participate in cytotoxic phenomena. The second phase consists of recognition of bacterial antigens by helper CD4 lymphocytes, which mainly release IL2 and IFNg (Th1 response). This cellular activation leads to the third phase: amplification of cytotoxic populations capable of killing tumour cells: CD8, gd lymphocytes, macrophages, NK, LAK, BAK cells. All these cells also produce cytokines, which participate in regulation of the immune response. The understanding of these mechanisms of action, urinary cytokine assays, a better definition of cytotoxic cells and their role, molecular analysis of the tumour and probably certain genetic characteristics of the host will allow the elaboration of more effective immunization protocols by defining an individualized therapeutic approach.

Adjuvants, Immunologic↗
PubMed1999

Partial nephrectomy with retroperitoneal laparoscopy.

PURPOSE: Laparoscopy has gradually gained acceptance for a variety of ablative procedures of the retroperitoneal organs, and the indications are being extended to more complex reconstructive and organ preserving procedures. We report our experience with retroperitoneal laparoscopic partial nephrectomy. MATERIALS AND METHODS: Retroperitoneal laparoscopic partial nephrectomy was performed for benign conditions in 6, equivocal solid masses in 4 and indeterminate cysts in 3 patients. If malignancy was suspected, laparoscopic sonography was used to assess the intrarenal anatomy and the mass. To facilitate parenchymal closure during nephron sparing surgery we used a hemostatic biological glue that consisted of gelatin, resorcinol and formaldehyde. RESULTS: Average operating time was 113 minutes and average blood loss was 72 ml. Histological examination revealed malignancy in 1 of the 3 cystic lesions and 2 of the 4 equivocal solid masses. There were 2 postoperative urinomas. CONCLUSIONS: Partial nephrectomy with retroperitoneal laparoscopy is feasible, and has a reasonable operating time and blood loss. Laparoscopic ultrasound was an important decision making aid during surgery. The use of biological glue simplified hemostasis and closure of the collecting system but good quality drainage of the collecting system is still required to decrease the risk of urinoma. The development of surgical tools that allow bloodless and nontraumatic section of the renal parenchyma is required to facilitate laparoscopic nephron sparing surgery. The ultrasonic scalpel needs further evaluation in this setting.

Adolescent↗
PubMed1999

Perineal approach to radical prostatectomy in kidney transplant recipients with localized prostate cancer.

Close urologic follow-up of renal transplant candidates and recipients often reveals prostate carcinoma at an early stage. Two patients who underwent renal transplantation for end-stage disease also underwent radical perineal prostatectomy for localized prostate carcinoma, 3 years after grafting in 1 patient and 4 years before grafting in the other. The perineal approach to prostatectomy may facilitate later renal transplantation and avoid allograft damage.

Adenocarcinoma↗
PubMed1999

Results of pyeloureterostomy after ureterovesical anastomosis complications in renal transplantation.

OBJECTIVES: The most frequent urologic complications after renal transplantation involve the ureterovesical anastomosis (ie, leakage, stenosis, and reflux), with a frequency of 1% to 30% in different series. We present the results of pyeloureterostomy using the recipient's ureter. METHODS: From 1988 to 1996, 570 cadaveric renal grafts were performed at our institution. A Lich Gregoir ureterovesical anastomosis was used in every case. Complications involving the anastomosis occurred in 19 cases (3.3%), with 10 stenoses (1.7%), 6 cases of leakage (1.1%), and 3 of reflux (0.5%). The mean donor age was 36.2 years, and the mean duration of cold ischemia was 29.4 hours. The mean recipient age was 41.3 years. Corrective surgery was performed 0.09 years (range 0.01 to 0.22) after transplantation for leakage, 1.13 years (range 0.14 to 5.11) for stenosis, and 5.55 years (range 0.51 to 9.71) for reflux. The recipient's ureter was stented with a ureteral catheter before median laparotomy, except in 3 cases of early leakage (less than 3 days). The recipient's ureter was cut, without the need for ipsilateral nephrectomy, and sutured to the graft pelvis. A nephroureterostomia stent (Gil Vernet stent) (12 cases) or a double J ureteral stent (7 cases) was used for urinary drainage. RESULTS: One graft was lost on day 1 through renal vein thrombosis. Percutaneous nephrostomy was performed on day 2 to clear an obstruction of the double J ureteral stent in one case, and a double J ureteral stent was inserted on day 2 because the nephrouretrostomia stent was incorrectly positioned in another case. Pyelographic controls on day 15 were normal in every case. The mean follow-up was 2.25 years (range 0.24 to 6.1) (2.9 years for leakage, 2.08 years for stenosis, and 1.44 years for reflux). One patient died with a functional graft 3 years after surgery. One graft was lost 4 years after surgery through chronic rejection. There were no complications affecting the ipsilateral kidney. No further ureteral complications occurred after surgery. The mean creatinine level 3 years after surgery was 1.59 mg/dL. CONCLUSIONS: Pyeloureterostomy is a safe and permanent treatment for complications of ureterovesical anastomosis and gives excellent results. The technique requires stenting of the recipient's ureter and graft drainage with a nephroureterostomia stent or a double J ureteral stent.

Adult↗
PubMed1999

Is open surgery for partial nephrectomy an obsolete surgical procedure?

During the past few years, the indications for laparoscopic surgery in urology have extended from simple ablative procedures towards more complex reconstructive and organ-preserving interventions. Among them, transperitoneal and extraperitoneal laparoscopic partial nephrectomy have been successfully performed for both benign and malignant lesions. However, this approach raises specific problems because in contrast to other laparoscopic procedures the techniques and tools used during open surgery can not be simply transposed to laparoscopy. The absence of surface hypothermia, the lack of manual palpation, difficulties of vascular control and reconstruction of the collecting system necessitate new solutions readily adaptable to laparoscopic surgery. However, the available series comprise only a few cases, and there are differences in techniques and instrumentation in almost every operation. In these circumstances, it is too early to consider this new approach as reproducible and ready to be used elsewhere than in specialized centres. Although the feasibility and good results of partial nephrectomy for benign conditions and small exophitic tumours is now well documented, the development of new surgical tools and standardization of methodology are required for more complex cases within the scope of well conceived prospective studies.

Blood Loss, Surgical↗
PubMed1999

Value of ultrasound-guided systematic sextant biopsies in prostate tumor mapping.

OBJECTIVE: To determine the value of positive sextant biopsies in assessing the location of prostate tumors within radical prostatectomy specimens and to determine if prostate weight influences the results. METHODS: From 1988 to 1996, 166 radical prostatectomies were performed for localized prostate cancer diagnosed by means of ultrasound-guided sextant biopsies. The location of the biopsies was compared with that of tumor tissue within the radical prostatectomy specimen. RESULTS: Of the 996 biopsies, 331 (33%) were positive. The correspondence between the location of the biopsies and that of tumor tissue in the surgical specimen was found to have a sensitivity of 39.4%, a specificity of 81.5%, a positive predictive value of 83.3%, negative predictive value of 36.4% and an accuracy of 52%. For prostates weighing < and >/= 45 g, the sensitivity was 39.9 and 38.9%, the specificity was 88 and 77.2%, the positive predictive value was 90.8 and 76.1%, the negative predictive value was 34.9 and 39.8%, and the accuracy was 52 and 52%, respectively. CONCLUSION: Negative biopsies do not predict a lack of tumor tissue in the corresponding prostate site after radical prostatectomy, and had less value than positive biopsies for prognostic staging before radical prostatectomy. Results of sextant biopsies are more significant for prognosis before radical prostatectomy when positive. Prostate weight influences the interpretation of the results of sextant biopsies.

Aged↗
PubMed1999

Retroperitoneal laparoscopic versus open radical nephrectomy.

PURPOSE: We analyze the retroperitoneal approach to laparoscopic radical nephrectomy in regard to feasibility, safety, morbidity and cancer control, and compare results and outcomes in patients who underwent retroperitoneal laparoscopic or open radical nephrectomy from 1995 to 1998. MATERIALS AND METHODS: The records of 58 consecutive patients with renal cancer who underwent radical nephrectomy from 1995 through 1998 were reviewed. Of the patients 29 underwent open radical nephrectomy (group 1) and 29 underwent retroperitoneal laparoscopic radical nephrectomy (group 2). Various parameters were compared and statistical analyses were performed. RESULTS: The 2 groups were similar in regard to age, gender and side of the tumor. Operative time was slightly shorter in group 1 (mean 121.4 versus 145 minutes in group 2, p = 0.047). Mean tumor size plus or minus standard deviation was larger in group 1 (5.71 +/- 2.01 versus 4.02 +/- 1.87 cm. in group 2). Group 2 patients had significantly less operative blood loss (mean 100.0 versus 284.5 ml. in group 1, p < 0.005) and used significantly less parenteral pain medication (p < 0.05). Postoperative hospital stay was significantly longer in group 1 (9.7 +/- 3.6 versus 4.8 +/- 2.0 days in group 2, p < 0.001), and the complication rate was higher (24 versus 8%, respectively). One group 1 patient died of renal cancer (pT2G2) after 14 months and local recurrence with hepatic metastasis occurred after 9 months in a group 2 patient with a pT3G2 tumor. CONCLUSIONS: Retroperitoneal laparoscopic nephrectomy for kidney cancer requires further assessment. It seems to have several advantages over open radical nephrectomy, and to be effective and safe for less than 50 cm. renal tumors but a risk of spillage cannot be ruled out for larger tumors.

Adult↗
PubMed1999

[Retrospective study of laparoscopic peritoneal radical nephrectomy].

OBJECTIVE: To analyse the results of laparoscopic radical nephrectomy in terms of feasibility, safety, morbidity and tumour control. MATERIAL AND METHODS: Between August 1993 and July 1998, 29 laparoscopic retroperitoneal radical nephrectomies were performed in 17 men and 12 women for renal tumours less than or equal to 90 mm in diameter. The working space was created by finger dissection without using a dilatation balloon. Four additional trocars were inserted under digital control. The renal pedicle was dissected first: the renal artery was clipped and the renal vein was sectioned by EndoGIA. After sectioning the ureter, the kidney was dissected with the perirenal fat and Gerota's fascia. The operative specimen was extracted in an impermeable endoscopy bag, without division, by enlarging the first trocar incision to 50 mm in order to avoid any parietal contact. RESULTS: The mean age of the patients was 61.3 years (range: 40 to 78 years). Radical nephrectomy was performed on 13 right kidneys and 16 left kidneys, with mean dimensions of 112.9 mm (range: 85 to 150 mm). The mean tumour diameter was 40.2 mm (range: 20 to 90 mm). The mean operating time was 145 min (range: 80 to 330 min) with a mean blood loss of 100 cc (range: 0 to 1000 cc). A mean daily dose of 2.8 g (range: 1 to 5 g) of parenteral paracetamol and a mean daily dose of 1.8 mg (range: 0 to 10 mg) of morphine hydrochloride were necessary postoperatively. The mean hospital stay was 4.8 days (range: 1 to 11 days). One intraoperative haemorrhage required open conversion and one colon injury was treated by temporary colostomy. One local recurrence with hepatic metastasis occurred 9 months after the operation in a patient operated for a Furhman grade II stage pT3 tumour with negative resection margins. CONCLUSION: Laparoscopic radical nephrectomy is currently under evaluation. This technique is feasible, and respects the principles of cancer surgery: primary control of renal vessels, en bloc extraction of the kidney with Gerota's fascia.

Adenocarcinoma↗