Abstract：Objective: To investigate the feasibility of conversion of retroperitoneal laparoscopy to peritoneal laparoscopy in laparoscopic radical nephrectomy for complicated renal tumor. Methods: Four patients with complicated renal tumors from Jan. 2013 to Jan. 2014 were treated by laparoscopic radical nephrectomy. Because the renal tumors adhered to the surrounding organs and the separation of the tumors was difficult, retroperitoneal laparoscopy was changed to peritoneal laparoscopy. The operative time, warm ischemia time, bleeding volume, perioperative complications and prognosis were all observed. Results: All the surgeries of the 4 cases were completed successfully. The average operative time was 75 min (60-90 min). The average bleeding volume during operation was 120 mL (80-200 mL) and there was no delayed hemorrhage. The average hospital stay (days) was 7.5 days (6 -9 days). Postoperative pathological examination revealed that there were 3 cases of renal clear cell carcinoma and one case of renal papillary carcinoma. The surgical margins were all negative. There was no recurrence in all the cases during a follow-up period of 3 cases. Conclusions: Change from the retroperitoneal to transperitoneal approaches in laparoscopic radical nephrectomy is safe and effective, and has less complications.
