Retroperitoneal laparoscopic nephrectomy for the patients undergoing peritoneal dialysis

Czech version

Authors: K. Morita; D. Iwami; N. Fukuzawa; T. Mitsui; A. Sazawa; N. Miyajima; N. Taniguchi; K. Nonomura
Published in: Urol List 2013; 11(1): 31-34

Overview

Peritoneal damage should be avoided at the nephrectomy in patients with end-stage renal disease treated by peritoneal dialysis (PD). We challenged to preserve peritoneum and peritoneal cavity with retroperitoneal nephrectomy in two adult PD patients. 36-year-old woman and 61-year-old man underwent retroperitoneal nephrectomy due to renal tumors. The former patient who had been treated with PD for 19 months presented bilateral renal mass (28 mm renal tumor in lower pole of left kidney and two aneurysmal tumors in middle of right kidney). She underwent staged retroperitoneal laparoscopic surgeries (left partial nephrectomy and right nephrectomy) uneventfully. Operation time was 217 and 105 minutes. Left renal cell carcinoma (RCC) (G1, pT1a) and right renal aneurysm (32 mm) were proven in pathology. The latter patient had been treated with PD for 11 months presented a 29 mm of renal tumor in lower pole of left kidney. He underwent retroperitoneal laparoscopic nephrectomy uneventfully. Operation time was 140 min. Pathology of the tumor was RCC (G2, pT1a). PD was restarted 48 hours after the surgery in both patients without any troubles. Daily urine volume of former woman decreased from 600 ml to 300 ml, that of latter man decreased from 2,000 ml to 1,300 ml. She was converted to hemodialysis 6 months after surgery because of PD dysfunction (low clearance), while he is now maintained with PD 8 months after surgery. Retroperitoneal laparoscopic approach was beneficial for keeping on PD procedure.

Key words:
peritoneal dialysis, retroperitoneal laparoscopic, nephrectomy, minimally invasive, perinetoneum preservation

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