Vascular Control Techniques In Hand-assisted Laparoscopic Radical Nephrectomy:Endo-GIA Or Hem-O-lok?

Objective:To evaluate the safety and economy of different vascular control techniques in hand-assisted laparoscopic radical nephrectomy, with the experience of Kidney Transplantation Departments of Shandong Provincial Hospital.Methods:The retrospective study included forty-nine cases of hand-assisted laparoscopic radical nephrectomy performed in our hospital from Jan2010to Oct2013.7. The mean age of the patients was52.6±10.6years old and all of them were diagnosed of renal cell carcinoma by ultrasound and enhanced CT.2cases were found thrombosis in their renal veins. All the49cases of patients were treated with intraperitoneal hand-assisted laparoscopic radical nephrectomy and vascular control was achieved respectively by application of Endo-GIA stapler (GROUP A, twenty-one cases) or Hem-0-lok clips (GROUP B, twenty-eight cases).Results:All procedures were completed successfully. None of the cases experienced conversion to open surgery or vascular complications. The mean estimated blood loss were78.3ml vs92.1ml (P=0.244), and the mean operative time were75.7min vs94.1min(P=0.059). The postoperative hospital stay were7.52d vs7.29d (P=0.761). Drainage of the first1and3day respectively were145.76ml vs172.54ml (P=0.143) and282.67ml vs403.35ml(P=0.018). Mean cost were3651.90Yuan vs2781.43Yuan (P=0.008)Conclusions:Endo GIA and Hem-O-lok are both safe in hand-assisted laparoscopic radical nephrectomy. However, Hem-O-lok is a more economical device and it’s a good choice for experienced surgeons.