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Evolving renorrhaphy technique for retroperitoneal laparoscopic partial nephrectomy: Single‐surgeon series
Author(s) -
Wahafu Wasilijiang,
Ma Xin,
Li HongZhao,
Ding Qiang,
Wang BaoJun,
Shi TaoPing,
Zheng Tao,
Dong Jun,
Cai Wei,
Zhang Xu
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12470
Subject(s) - medicine , nephrectomy , barbed suture , perioperative , fibrous joint , renal function , surgery , kidney
Objectives To evaluate renorrhaphy techniques and to analyze surgical outcomes in retroperitoneal laparoscopic partial nephrectomy. Methods A retrospective study from J anuary 2008 to D ecember 2011 analyzed 526 patients with renal tumors in whom renorrhaphy was changed from one layer, interrupted, figure‐of‐eight ( n = 228) suture to two layers, continuous, unknotted ( n = 298) suture. All procedures were carried out by the same laparoscopic surgeon ( XZ ). Patient demographics, tumor characteristics, operative outcomes and perioperative renal function were compared. Results Median follow up for one layer, interrupted, figure‐of‐eight suture and two layers, continuous, unknotted suture was 31 and 28 months, respectively. The two layers, continuous, unknotted suture group had shorter warm ischemia time ( P = 0.021), faster removal of J ackson‐ P ratt drains ( P = 0.029) and shorter hospital stay ( P = 0.037) than the one layer, interrupted, figure‐of‐eight suture group. There was a trend towards a better preservation of glomerular filtration rates in the two layers, continuous, unknotted suture group ( P = 0.045). In a multivariable model, the two layers, continuous, unknotted suture technique was a statistically significant independent predictor of warm ischemia time ( P = 0.01), hospital stay ( P = 0.001) and estimated glomerular filtration rates ( P = 0.043). Conclusions Two layers, continuous, unknotted suture renorrhaphy allows better outcomes than one layer, interrupted, figure‐of‐eight suture renorrhaphy in retroperitoneal laparoscopic partial nephrectomy. A longer clinical follow‐up evaluation is warranted.