Efficacy And Safety Of Transperitoneal Approach And Retroperitoneal Approach Laparoscopic Nephron-sparing Surgery For The Treatment Of Renal Hamartoma

Objective:To explore the efficacy and safety of transperitoneal and retroperitoneal laparoscopic nephron-sparing surgeries in the treatment of renal hamartoma(RAML).Methods:We retrospectively analyzed and summarized the clinical data of 39 patients with RAML treated in our hospital from January 2013 to October2017.According to the operation method,the patients were divided into two groups:21 cases undergoing transperitoneal laparoscopic nephron-sparing sugery(TLNSS)and 18 cases after retroperitoneal laparoscopic nephron-sparing sugery(RLNSS).The general data,operation and postoperative related indexes of two groups were compared to evaluate the curative effect of the two surgical methods.Results:There was no significant difference in general data such as gender,age,tumor diameter between the two groups(P> 0.05);In the imaging examination,the number of tumors in the TLNSS group was significantly higher on the ventral side than in the RLNSS group,while the number of tumors on the lumbar side in the RLNSS group was significantly more than that on the TLNSS group(P <0.05);The operation time of TLNSS group and RLNSS group were(168.8±70.0)min and(120.5±53.9)min respectively,and the recovery time of intestinal function were(72.5±20.2)and(53.4±15.1).The recovery time of intestinal function after operation was longer than that of RLNSS group and the difference was statistically significant(P <0.05).Conclusion:It is safe and effective to treat RAML with laparoscopic by transperitoneal and retroperitoneal.The two surgical methods have their own advantages and disadvantages,transperitoneal suitable for tumor treatment is relatively difficult,located in the kidney outside the waist side of patients.And the retroperitoneal is suitable for patients with tumors located outside the ventral side of the kidney with rapid postoperative recovery.