A comparison of renal vascular control techniques during laparoscopic nephrectomy
Background: We compared outcomes of en bloc stapler ligation of the renal hilum with separate Hem-o-lok polymer clip ligation of the renal vessels during laparoscopic nephrectomy (LN). Materials and Methods: Clinical data of patients who underwent LN for renal surgery from January 2009 to December 2...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
|
| Series: | Journal of Minimal Access Surgery |
| Subjects: | |
| Online Access: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2021;volume=17;issue=2;spage=192;epage=196;aulast= |
| _version_ | 1818663177601155072 |
|---|---|
| author | Gokhan Koc Gokhan Rahmi Ekin Batuhan Ergani Yusuf Ozlem Ilbey |
| author_facet | Gokhan Koc Gokhan Rahmi Ekin Batuhan Ergani Yusuf Ozlem Ilbey |
| author_sort | Gokhan Koc |
| collection | DOAJ |
| description | Background: We compared outcomes of en bloc stapler ligation of the renal hilum with separate Hem-o-lok polymer clip ligation of the renal vessels during laparoscopic nephrectomy (LN).
Materials and Methods: Clinical data of patients who underwent LN for renal surgery from January 2009 to December 2015 were collected. Operation time, estimated blood loss, device malfunction rate, open conversion rate, complications and arteriovenous fistula (AVF) formation were evaluated.
Results: En bloc stapler ligation and separate clip ligation were performed in 64 and 66 patients, respectively. The mean operative time was 106.8 ± 20.8 min (range: 70–165) in the en bloc stapler ligation group compared with 112.5 ± 24.1 min (range: 70–180) in the separate clip ligation group (P = 0.147). The mean estimated blood loss was 141.4 ± 124.1 ml (range: 25–600) in the en bloc stapler ligation group compared with 147.6 ± 112.4 ml (range: 25–450) in the separate clip ligation group (P = 0.767). The open conversion was required in 7/64 (10.9%) and 2/66 (3.0%) patients in the en bloc stapler ligation and separate clip ligation groups, respectively (P = 0.093). Stapler device malfunction occurred in 6 patients (9.3%). There were no statistically significant differences in overall complications (P = 0.726), minor (Grade 1–2) complications (P = 0.698) and major (Grade 3–5) complications (P = 0.716). No patient was diagnosed with AVF formation during overall median 33-month (interquartile range: 30, range: 24–96) follow-up.
Conclusions: En bloc stapler ligation of the renal hilum during nephrectomy is an effective and safe technique. Although there is no reported AVF formation with en bloc stapler ligation of the renal hilum, longer follow-up is necessary. |
| first_indexed | 2024-12-17T05:12:42Z |
| format | Article |
| id | doaj.art-921af73e4b6140bb899830a6df838933 |
| institution | Directory Open Access Journal |
| issn | 0972-9941 1998-3921 |
| language | English |
| last_indexed | 2024-12-17T05:12:42Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj.art-921af73e4b6140bb899830a6df8389332022-12-21T22:02:13ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212021-01-0117219219610.4103/jmas.JMAS_287_19A comparison of renal vascular control techniques during laparoscopic nephrectomyGokhan KocGokhan Rahmi EkinBatuhan ErganiYusuf Ozlem IlbeyBackground: We compared outcomes of en bloc stapler ligation of the renal hilum with separate Hem-o-lok polymer clip ligation of the renal vessels during laparoscopic nephrectomy (LN). Materials and Methods: Clinical data of patients who underwent LN for renal surgery from January 2009 to December 2015 were collected. Operation time, estimated blood loss, device malfunction rate, open conversion rate, complications and arteriovenous fistula (AVF) formation were evaluated. Results: En bloc stapler ligation and separate clip ligation were performed in 64 and 66 patients, respectively. The mean operative time was 106.8 ± 20.8 min (range: 70–165) in the en bloc stapler ligation group compared with 112.5 ± 24.1 min (range: 70–180) in the separate clip ligation group (P = 0.147). The mean estimated blood loss was 141.4 ± 124.1 ml (range: 25–600) in the en bloc stapler ligation group compared with 147.6 ± 112.4 ml (range: 25–450) in the separate clip ligation group (P = 0.767). The open conversion was required in 7/64 (10.9%) and 2/66 (3.0%) patients in the en bloc stapler ligation and separate clip ligation groups, respectively (P = 0.093). Stapler device malfunction occurred in 6 patients (9.3%). There were no statistically significant differences in overall complications (P = 0.726), minor (Grade 1–2) complications (P = 0.698) and major (Grade 3–5) complications (P = 0.716). No patient was diagnosed with AVF formation during overall median 33-month (interquartile range: 30, range: 24–96) follow-up. Conclusions: En bloc stapler ligation of the renal hilum during nephrectomy is an effective and safe technique. Although there is no reported AVF formation with en bloc stapler ligation of the renal hilum, longer follow-up is necessary.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2021;volume=17;issue=2;spage=192;epage=196;aulast=en blochem-o-lok cliplaparoscopic nephrectomymalfunctionstapler |
| spellingShingle | Gokhan Koc Gokhan Rahmi Ekin Batuhan Ergani Yusuf Ozlem Ilbey A comparison of renal vascular control techniques during laparoscopic nephrectomy Journal of Minimal Access Surgery en bloc hem-o-lok clip laparoscopic nephrectomy malfunction stapler |
| title | A comparison of renal vascular control techniques during laparoscopic nephrectomy |
| title_full | A comparison of renal vascular control techniques during laparoscopic nephrectomy |
| title_fullStr | A comparison of renal vascular control techniques during laparoscopic nephrectomy |
| title_full_unstemmed | A comparison of renal vascular control techniques during laparoscopic nephrectomy |
| title_short | A comparison of renal vascular control techniques during laparoscopic nephrectomy |
| title_sort | comparison of renal vascular control techniques during laparoscopic nephrectomy |
| topic | en bloc hem-o-lok clip laparoscopic nephrectomy malfunction stapler |
| url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2021;volume=17;issue=2;spage=192;epage=196;aulast= |
| work_keys_str_mv | AT gokhankoc acomparisonofrenalvascularcontroltechniquesduringlaparoscopicnephrectomy AT gokhanrahmiekin acomparisonofrenalvascularcontroltechniquesduringlaparoscopicnephrectomy AT batuhanergani acomparisonofrenalvascularcontroltechniquesduringlaparoscopicnephrectomy AT yusufozlemilbey acomparisonofrenalvascularcontroltechniquesduringlaparoscopicnephrectomy AT gokhankoc comparisonofrenalvascularcontroltechniquesduringlaparoscopicnephrectomy AT gokhanrahmiekin comparisonofrenalvascularcontroltechniquesduringlaparoscopicnephrectomy AT batuhanergani comparisonofrenalvascularcontroltechniquesduringlaparoscopicnephrectomy AT yusufozlemilbey comparisonofrenalvascularcontroltechniquesduringlaparoscopicnephrectomy |