کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
3844732 | 1248164 | 2006 | 9 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: NefrectomÃa laparoscópica mano-asistidaHand-assisted laparoscopic nephrectomy NefrectomÃa laparoscópica mano-asistidaHand-assisted laparoscopic nephrectomy](/preview/png/3844732.png)
ResumenIntroducción y ObjetivosPresentamos nuestra casuÃstica de nefrectomÃas laparoscópicas mano-asistidas. Se valoran nuestros resultados y las dificultades del inicio de un programa progresivo de laparoscopia.MaterialDesde noviembre 2003 hasta noviembre 2005 se han realizado 35 nefrectomÃas laparoscópicas Mano-asistidas, de un total de 45 nefrectomÃas laparoscópicas. 22 nefrectomÃas radicales, 3 nefrectomÃas simples y 10 nefroureterectomÃas. Media de edad 66 años (47-89). TenÃan una media de sobrepeso (IMC 28,3); 38% eran obesos. ASA 2,3 (1-4). Los tumores tenÃan 4,8 cm de tamaño medio; 80% eran T1. El 28,6% habÃan sido operados previamente de cirugÃa abdominal.ResultadosSe realizaron 1 en 2003, 17 en 2004, y 17 en 2005. El tiempo quirúrgico ha sido 140 minutos, 130 minutos (80-210) en nefrectomÃas radicales, 135 minutos (120-150) en nefrectomÃas simples y 163 minutos (80-240) en nefroureterectomÃas. Los pacientes iniciaron dieta oral en 1,7 dÃas y se levantaron en 1,7 dÃas. Los obesos iniciaron la dieta (2,3 dÃas) y se levantaron (2,4 dÃas) más tarde que los no obesos (1,5 y 1,4 dÃas respectivamente). La estancia media ha sido 5,8 dÃas (3-15); en los no complicados 4,2 dÃas y en los que han tenido complicaciones 9,7 dÃas. En ningún caso se trasfundió. Hemos tenido 11,4% de complicaciones mayores con EM de 11,7 dÃas. Un 5,7% de reconversiones y 5,7% de reoperaciones. Y 17,1% de complicaciones menores, con EM de 8,8 dÃas.ConclusionesLa nefrectomÃa mano-asistida es una técnica que por sus ventajas permite un inicio en la laparoscopia, con menor curva de aprendizaje, y resultados satisfactorios, permitiendo incorporar la cirugÃa laparoscópica a hospitales con un menor volumen anual.
Introduction and objectivesTo present the number of cases of hand-assisted laparoscopic nephrectomy. This study evaluates our results and difficulties of starting a progresive programme of laparoscopy.Material and MethodBetween november 2003 and november 2005, 35 hand-assisted laparoscopic nephrectomies were carried out, of a total of 45 laparoscopic nephrectomies. 22 radical nephrectomies, 3 simple nephrectomies and 10 nephroureterectomies. The average age of patients was 66 years (47-89). On average, they were overweight (IMC 28,3), with approximately 38% being obese. ASA 2.3 (1-4). The tumors measured 4.8cm on average, and 80% of these were T1. In 28.6% of the cases, they had previously undergone abdominal surgery.ResultsOne was undertaken in 2003, 17 in 2004, and 17 in 2005. The surgery time was 140 minutes, 130 minutes (80-210) in radical nephrectomies, 135 minutes (120-150) in simple nephrectomies and 163 minutes (80-240) in the nephroureterectomy. Patients began an oral diet 1.7 days later, and were able to get up 1.7 days later. In the case of obese patients, they began an oral diet 2.3 days later and were able to get up (2.4 days) later than those non obese cases. (1.5 and 1.4 days respectively). The average stay has been 5.8 days (3-15). The average stay of the cases without complications was 4.2 days and those that encountered complications 9.7 days. In no cases was there a need for a blood transfusion. In 11.4% we had major complications with an average stay of 11.7 days. In 5.7% of cases there were reconversions, and 5.7% of cases were reoperated. 17.1% had minor complications, with an average stay of 8.8 daysConclusionsThe advantage of hand-assisted nephrectomy is that it allows one to begÃn a laparoscopy, with a reduced learning time, and with satisfactory results, allowing the incorporation of laparoscopy surgery in hospitals with a reduced annual volume.
Journal: Actas Urológicas Españolas - Volume 30, Issue 7, 2006, Pages 698-706