ArticleMedicine and pharmacy reports2022
Technical challenges of lymphadenectomy in renal carcinoma performed with a 3D laparoscopic approach at a low pressure pneumoperitoneum due to associated pulmonary pathology - case report.
Article in Medicine and pharmacy reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
We report the case of a 63-year-old male patient presenting left renal cell carcinoma (75/70/60 mm) associated with retroperitoneal lymph node masses (peri hilar of 15 mm; lombo-aortic of 50/40/30 mm), known also with chronic obstructive pulmonary disease GOLD4, sleep apnea and asthma with oxygen-dependent chronic obstructive respiratory insufficiency, a BMI of 37 with grade III obesity. Surgical treatment was performed using a 3D transperitoneal laparoscopic approach. The surgery lasted 131 minutes, with 400 ml blood loss and grade 1 Clavien-Dindo post operative complications. An optimal pulmonary ventilation of the patient during surgery required a low intra-abdominal pressure (10 mmHg) which raised technical difficulties due to the lymph node mass dissection from the great vessels in a small operative field on an already obese patient with a voluminous renal tumor. The 3D transperitoneal laparoscopic approach was feasible within safe oncologic parameters.
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