A single-centre clinical experience on 3D/2D retroperitoneal laparoscopic nephrectomy

doi:10.3877/cma.j.issn.1674-3253.2019.05.008

Abstract

Abstract:

Objective

To compare the clinical effect of 3D and 2D retroperitoneal laparoscopic nephrectomy, and summarize the surgical experience of retroperitoneal laparoscopic nephrectomy.

Methods

The clinical data of 69 cases with nonfunctioning kidney who were treated in our department from February 2015 to February 2018 were analyzed retrospectively. 29 cases in group A used laparoscopic 3D system, and 40 cases in group B used 2D laparoscopic system. The operative time, intraoperative blood loss, postoperative intestinal exhaust time, postoperative drainage time, hospital time, transit open surgery and complications were compared between the two groups.

Results

69 cases were performed by the same surgeon. 61 cases (88.4%) were treated by retroperitoneal laparoscopic nephrectomy successfully. 8 cases were transferred to open surgery due to severe adhesion (or massive bleeding). The operation time in group A was significantly shorter than that in group B[(118±21) min vs (134±19) min,t=-3.3003,P=0.0008]. There was no significant difference in intraoperative blood loss, postoperative intestinal exhaust time, postoperative drainage time, hospital time and operative complications between the two groups (P>0.05).

Conclusion

Retroperitoneal laparoscopic nephrectomy is a safe and effective nephrectomy method. Compared with 2D laparoscopic system, 3D laparoscopic systems can effectively shorten the operation time after being skilled, it is worthy of clinical application.

Key words: 3D, laparoscopy, 2D laparoscopy, Nephrectomy

Xiaofang Bi, Qinrong Ping, Chunhui Wang, Jie Xiong, Rui Gong, Yingbao Wang, Jian Li, Yiming Zhong, Hui Li. A single-centre clinical experience on 3D/2D retroperitoneal laparoscopic nephrectomy[J]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(05): 317-320.

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Figures/Tables 3

References 12

[1]	Clayman RV, Kavoussi LR, Soper NJ, et al. Laparoscopic nephrectomy: initial case report[J]. J Urol, 1991, 146(2): 278-282.
[2]	Gaur DD. Laparoscopic operative retroperitoneoscopy: use of a new device[J]. J Urol, 1992, 148(4): 1137-1139.
[3]	Game X, Binhazzaa M, Soulie M, et al. Three-dimensional laparoscopy for living-donor nephrectomy with vaginal extraction: the first case[J]. Int J Surg Case Rep, 2017, 34: 87-89.
[4]	Weiner AB, Matulewicz RS, Meeks JJ. Robotic-assisted vs laparoscopic radical nephrectomy[J]. JAMA, 2018, 319(11): 1165.
[5]	Xu W, Li H, Ji Z, et al. Comparison of three dimensional and two dimentional laparoscopic pyeloplasty for ureteropelvic junction obstruction[J]. Zhonghua Wai Ke Za Zhi, 2014, 52(10): 771-774.
[6]	Harada H, Kanaji S, Hasegawa H, et al. The effect on surgical skills of expert surgeons using 3D/HD and 2D/4K resolution monitors in laparoscopic phantom tasks[J]. Surg Endosc, 2018，32(10): 4228-4234.
[7]	Fergo C, Burcharth J, Pommergaard HC, et al. Three-dimensional laparoscopy vs 2-dimensional laparoscopy with high-definition technology for abdominal surgery: a systematic review[J]. Am J Surg, 2017, 213(1): 159-170.
[8]	Sorensen SM, Savran MM, Konge L, et al. Three-dimensional versus two-dimensional vision in laparoscopy: a systematic review[J]. Surg Endosc, 2016, 30(1): 11-23.
[9]	Harada H, Kanaji S, Nishi M, et al. The learning effect of using stereoscopic vision in the early phase of laparoscopic surgical training for novices[J]. Surg Endosc, 2018, 32(2): 582-588.
[10]	Chauhan N, Kenwar DB, Singh N, et al. Retroperitoneal single port versus transperitoneal multiport donor nephrectomy: a prospective randomized control trial[J]. J Endourol, 2018, 32(6):496-501.
[11]	陈光彪，湛海伦，周建新, 等. 腹腔镜结核性无功能肾切除的手术技巧[J/CD]. 中华腔镜外科杂志(电子版), 2015, 9(4): 280-284.
[12]	黄细汉，湛海伦，周祥福, 等. 后腹腔镜巨大肾积水切除的手术技巧[J/CD]. 中华腔镜外科杂志(电子版), 2015, 9(1): 70-72.

组别	例数	年龄（岁，±s）	性别（例）		位置（例）		患侧肾小球滤过率（ml/min，±s）	既往史（例）
组别	例数	年龄（岁，±s）	男	女	左侧	右侧	患侧肾小球滤过率（ml/min，±s）	穿刺造瘘	肾或输尿管手术	体外碎石
A组	29	44±11	16	13	15	14	7.2±1.4	7	8	6
B组	40	46±13	19	21	24	16	6.9±1.6	13	10	11
统计值	?	t=-0.863	χ²=0.396		0.468		t=0.809	χ²=0.571	χ²=0.058	χ²=0.420
P值	?	0.196	0.529		0.494		0.211	0.449	0.809	0.517

组别	例数	年龄（岁，±s）	性别（例）		位置（例）		患侧肾小球滤过率（ml/min，±s）	既往史（例）
组别	例数	年龄（岁，±s）	男	女	左侧	右侧	患侧肾小球滤过率（ml/min，±s）	穿刺造瘘	肾或输尿管手术	体外碎石
A组	29	44±11	16	13	15	14	7.2±1.4	7	8	6
B组	40	46±13	19	21	24	16	6.9±1.6	13	10	11
统计值	?	t=-0.863	χ²=0.396		0.468		t=0.809	χ²=0.571	χ²=0.058	χ²=0.420
P值	?	0.196	0.529		0.494		0.211	0.449	0.809	0.517

组别	例数	腔镜成功率[例（%）]	手术时间（min，±s）	术中出血量（ml，±s）	术后通气时间（h，±s）	拔除引流管时间（d，±s）	住院时间（d，±s）
A组	29	26（89.7）	118±21	58±12	21.5±4.6	2.5±0.3	7.5±1.1
B组	40	35（87.5）	134±19	63±15	20.8±5.3	2.4±0.5	7.3±0.9
统计值	?	χ²=0.011	t=-3.300	t=-1.307	t=0.572	t=0.958	t=0.830
P值	?	0.916	0.001	0.098	0.285	0.171	0.205

组别	例数	腔镜成功率[例（%）]	手术时间（min，±s）	术中出血量（ml，±s）	术后通气时间（h，±s）	拔除引流管时间（d，±s）	住院时间（d，±s）
A组	29	26（89.7）	118±21	58±12	21.5±4.6	2.5±0.3	7.5±1.1
B组	40	35（87.5）	134±19	63±15	20.8±5.3	2.4±0.5	7.3±0.9
统计值	?	χ²=0.011	t=-3.300	t=-1.307	t=0.572	t=0.958	t=0.830
P值	?	0.916	0.001	0.098	0.285	0.171	0.205

组别	例数	中转开放	腹膜损伤	大出血	皮下气肿	术后发热	切口感染
A组	29	3（10.3）	2（6.9）	0（0）	2（6.9）	4（13.8）	1（3.4）
B组	40	5（12.5）	4（10.0）	1（2.5）	3（7.5）	6（15.0）	1（2.5）
χ²值	?	0.011	0.0001	-	0.141	0.042	-
P值	?	0.916	0.978	1.000	0.708	0.837	1.000

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