Abstract：Objective:To evaluate the technical feasibility and clinical efficacy of laparoscopic partial nephrectomy(LPN).Methods:Between March 2005 and June 2011, Retroperitoneal laparoscopic partial nephrectomy was performed on 205 patients with exophytic tumors (145 of renal carcinoma and 60 of renal harmatoma confirmed with pathology). Mean age was 52-year (range: 32-75-year). In all cases hilar were controlled by clamping the renal artery alone with endoscopic bulldog clamps within 30 minutes. Renal masses were excised with cold endoscissors. Hemostasis and repair of the collecting system were achieved by suture with 2-0 VICRYL.Results:Median tumor size was 2.8 cm (range: 1-5 cm). All of 205 operations were successfully performed, with a mean surgical time of 80 minutes (range 60 min to 150 min), and blood loss of 200 ml (range 100 to 800 ml), clamping time 20 min (range 9 to 30 min). Pathologic diagnosis: 145 renal-cell carcinoma; 60 hamartoma, all surgical margins were negative. 1 case suffered from bleeding at the operation night, and 2 cases bled two days later. For the 3 cases,we achieved a satisfy result by intervention embolization. Another 3 cases suffered from pseudoaneurysm 2 weeks after operation. we applied the intervention embolization and patients were cured. There were no patients suffering urinary fistula. The median follow-up for 205 cases is 36 months with a range between 6 to 56 month and no recurrence or metastasis were noted during our observation.Conclusions:Retroperitoneal laparoscopic partial nephrectomy has been proved to have distinct advantages of minor trauma and quick recovery compared with open partial nephrectomy. But the indication of operation should be strictly mastered.
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