MyMedR

Initial experience of laparoscopic retroperitoneal partial nephrectomy in an academic hospital in Malaysia

Khoo HC, Lim LY, Shukor S, Zainal Adwin ZA, Zulkifli MZ, Fam XI

Med J Malaysia, 2022 Nov;77(6):764-767.

Laparoscopic retroperitoneal partial nephrectomy (LRPN) is a technically demanding kidney surgery due to the limited space and unfamiliar approach in the retroperitoneal space. The aim of this study is to review the outcome of our initial experience in performing this procedure. All patients who underwent LRPN between 2019 to 2022 were included in this retrospective review. A total of 23 patients underwent LRPN. The mean operating time was 178±43 minutes and mean warm ischemia time was 20±5 minutes. The average estimated blood lost was 89±68ml and the mean postoperative hospital stay was 3.6±0.8 days. Two patients (11.1%) had positive margin and no local recurrence was seen after mean follow up of 15.8±12.0 months. Our initial experience on LRPN showed promising results to perform partial nephrectomy safely and effectively.

Matched MeSH terms: Retroperitoneal Space/surgery

Fulltext Robotic versus Laparoscopic Retroperitoneal Lymph node Dissection for Clinical Stage I Non-seminomatous Germ Cell Tumor of Testis: A Comparative Analysis

Xu Y, Li H, Wang B, Gu L, Gao Y, Fan Y, et al.

Urol J, 2021 Oct 04;18(6):618-622.

PMID: 34606083 DOI: 10.22037/uj.v18i.6629

PURPOSE: To compare the treatment outcomes of robotic retroperitoneal lymph node dissection (R-RPLND) versus laparoscopic RPLND (L-RPLND) for clinical stage I non-seminomatous germ cell testicular tumors (NSGCTs).

MATERIALS AND METHODS: We retrospectively reviewed the data of patients with stage I NSGCTs who underwent robotic or laparoscopic RPLND between 2008 and 2017. Perioperative data and oncologic outcomes were reviewed and compared between the two groups. Progression-free survival was analyzed using Kaplan-Meier survival curves and compared between two groups.

RESULTS: A total of 31 and 28 patients underwent R-RPLND and L-RPLND respectively. The preoperative characteristics of the patients were comparable in the two groups. Patients in R-RPLND group had significantly shorter median operative time (140 vs. 175 minutes, P < .001), a shorter median duration to surgical drain removal (2 vs. 4 days, P = .002) and a shorter median postoperative hospital stay (5 vs. 6 days, P = .001). There were no statistical differences in intra- and post-operative complication rate between the groups and the oncologic outcomes were similar in the two groups.

CONCLUSION: In expert hands, R-RPLND and L-RPLND were comparable in oncological parameter and morbidity rate; R-RPLND showed superiority in operation duration, median days to surgical drain removal and postoperative hospital stay for stage I NSGCTs. Multicenter and randomized studies with good power of study and sufficient follow-up duration are required to validate our result.

Matched MeSH terms: Retroperitoneal Space/pathology

Fulltext Case report of a difficult venous access: retroperitoneal approach of inserting an improved non-heparinised port for long-term use

Chan KY, Teoh CM, Sukumar N

Med J Malaysia, 2005 Mar;60(1):94-6.

PMID: 16250289

This is a case report of a patient with difficult venous access following thrombosis of major superficial and deep veins of the limbs as documented by ultrasound doppler and venography. The insertion of a few central ports were infected and the vein thrombosed. Venography revealed that central venous access was no longer feasible. The previous laparotomies had resulted in dense intra-peritoneal adhesions, and rendered further laparotomy virtually impossible. The patient had occasional adhesion colics, vomiting and hypoglycemic episodes. A rarely performed retro-peritoneal approach of inserting an improved non-heparinised port proved to be effective for long-term management of this patient. The surgical approach and the selected port are discussed.

Matched MeSH terms: Retroperitoneal Space/blood supply

Fulltext Huge Retroperitoneal Cyst Masquerading as Ovarian Tumour: A Case Report

Johan S, Hassan MF, Hayati F, Azizan N, Payus AO, Edwin See UH

Front Surg, 2020;7:585411.

PMID: 33195391 DOI: 10.3389/fsurg.2020.585411

Retroperitoneal cystic mass is a rare surgical condition that is often misdiagnosed preoperatively. Here, we report a case of a 56-year-old woman who presented with abdominal swelling for a 1-year duration, which was associated with lower abdominal pain for 6 months. Her abdominal radiograph showed a huge radiopaque lesion, and contrast-enhanced computed tomography scan of the abdomen reported it as a left ovarian serous cystadenoma causing local mass effect to the left ureter leading to mild left hydronephrosis. She underwent exploratory laparotomy and noted there was a huge retroperitoneal cystic mass. The histopathological assessment finding was consistent with a benign retroperitoneal cyst. This case report aims to share the rare case of primary retroperitoneal lesions, which can cause a diagnostic challenge preoperatively to all clinicians despite advanced achievement in medical imaging.

Matched MeSH terms: Retroperitoneal Space

Activated recombinant factor VII in the treatment of retroperitoneal haemorrhage in a patient with factor VIII inhibitor

Ng SC

Ann Acad Med Singap, 1994 Nov;23(6):901-2.

PMID: 7741509

The management of haemorrhagic episodes in patients with factor VIII inhibitor is difficult and the outcome rather unpredictable. The use of an investigational drug, that is, activated recombinant factor VII (rFVIIa) in a young non-haemophiliac patient with spontaneous occurrence of factor VIII inhibitor who presented with life-threatening retroperitoneal haemorrhage is reported. There was prompt achievement of haemostasis with rFVIIa after the patient had failed conventional therapy with factor IX and Autoplex. Two further episodes of retroperitoneal bleeding again responded promptly to rFVIIa therapy.

Matched MeSH terms: Retroperitoneal Space

Clinical Consultation Guide: Nerve-sparing Techniques for Retroperitoneal Lymph Node Dissection in Testicular Cancer

Khor V, Chen K, Somasundram LM, Lawrentschuk N

Eur Urol Focus, 2024 May;10(3):364-366.

PMID: 38839507 DOI: 10.1016/j.euf.2024.05.008

Reptroperitoneal lymph node dissection (RPLND) is associated with a risk of morbidity and ejaculatory dysfunction. Nerve-sparing RPLND shows promise in preserving ejaculation alongside oncological efficacy. Laparoscopic and robot-assisted modalities are feasible with good outcomes, highlighting the need for ongoing scientific research and refinement of surgical skills.

Matched MeSH terms: Retroperitoneal Space

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