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Lateral paramedian open radical nephrectomy for large renal mass; an unconventional incision in urology practice

Engin Ozbay, Halil Oncel, Remzi Salar, Emrullah Durmus.

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Background: This study aimed to retrospectively evaluate the surgical and pathological results of patients who underwent ORN (open radical nephrectomy) with an unconventional incision (lateral paramedian) applied to large renal mass in a non-academic urology clinic.
Subjects and Methods: The study included 46 patients who underwent ORN for a large renal mass between March 2014 and August 2019. The sociodemographic features of the patients, radiological features of the masses, surgical method, and pathology results were retrospectively evaluated.
Results: Thirteen female and 33 male patients were included in the study. Renal masses were observed in 22 patients with right side and 24 patients with left side. The mean age of the patients was 62.78±9.50 years. The mean renal mass diameter was 9.34±2.96 cm. RCC (Renal Cell Carsinom) was detected at a rate of 84.7%. The mean intraoperative bleeding was 226±121 cc and our transfusion rate was %4. The degree of early postoperative pain was medium at a rate of 89.1%. The mean operation time was 118.02±39.96 minutes. Wound infection and wound dehiscence did not occur in the early postoperative period. The mean length of hospital stay was 5.43±1.09 (4-8) days. Incisional hernia was not observed in patients.
Conclusions: Lateral paramedian incision can be safely preferred in the transperitoneal radical nephrectomy of large renal tumor, providing a clear intraoperative exposure, low postoperative complication rate and the good management of postoperative pain control. Low hospitalization time was remarkable. Our pathology results were similar to the literature.

Key words: Lateral Paramedian, Open Radical Nephrectomy, Large Renal Mass

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