Zusammenfassung
Seit der ersten laparoskopischen Nephrektomie durch Clayman 1990 wurden beinahe alle ablativen und rekonstruktiven operativen Maßnahmen an der Niere auch laparoskopisch durchgeführt. Für die gutartigen Erkrankungen konnte schon früh die Vorteile der Laparoskopie im Vergleich zur offenen Operation nachgewiesen werden. Diese zeigen sich in einem verringerten postoperativen Schmerzmittelkonsum, der kürzeren Hospitalisationsdauer, der kürzeren Rekonvaleszenz und als gut objektivierbare Parameter der geringere Anstieg von Interleukinen und Akute-Phase-Proteinen, als Ausdruck der geringeren Invasivität.
In einer Vielzahl von Publikationen ist in den letzten Jahren über die Wertigkeit der Laparoskopie in der Nierenchirurgie bei malignen Erkrankungen berichtet worden. Für die laparoskopische radikale Nephrektomie beim Nierenzellkarzinom und auch aus einigen Zentren für die laparoskopische Nierenteilresektion konnte eine Gleichwertigkeit zu den offen operativen Verfahren bezüglich des onkologischen Outcomes nachgewiesen werden, mit allen Vorteilen der minimal-invasiven Techniken. Neben der ständigen Weiterentwicklung der Technik ist die Verbreitung der Methode eine der wichtigen gegenwärtigen und zukünftigen Aufgaben.
Abstract
Since the first laparoscopic nephrectomy in 1990, most ablative and reconstructive urological kidney surgery has been attempted laparoscopically. The advantages of this method were first demonstrated for benign diseases, with less postoperative pain, shorter hospitalization, faster convalescence and, for the objective evaluation of these findings, with lower serum levels of interleukins and acute phase proteins, and without disadvantages in therapy efficiency.
Over the last few years, sufficient data have been published to show the oncological outcome for patients with kidney cancer. For laparoscopic radical nephrectomy, and recently also for partial nephrectomy, oncological equality with open procedures could be demonstrated, with all of the benefits of minimally invasive techniques. The use of laparoscopy was one of the most important steps in the progress of medicine in the 20th century. Our aims include the further improvement of this technique and its distribution to surgical centers.
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Literatur
Abukora F, Nambirajan T, Albqami N et al. (2005) Laparoscopic nephron sparing surgery: evolution in a decade. Eur Urol 47: 488–493
Albqami N, Janetschek G (2006) Indications and contraindications for the use of laparoscopic surgery for renal cell carcinoma. Nat Clin Pract Urol 3: 32–37
Allaf ME, Bhayani SB, Rogers C et al. (2004) Laparoscopic partial nephrectomy: evaluation of long-term oncological outcome. J Urol 172: 871–873
Bariol SV, Stewart GD, McNeill SA, Tolley DA (2004) Oncological control following laparoscopic nephroureterectomy: 7-year outcome. J Urol 172: 1805–1808
Beasley KA, Al OM, Shaikh A et al. (2004) Laparoscopic versus open partial nephrectomy. Urology 64: 458–461
Clayman RV (2005) Laparoscopic partial nephrectomy using microwave tissue coagulator for small renal tumors: usefulness and complications. J Urol 174: 1248
Clayman RV (2005) Comparison of open versus laparoscopic pyeloplasty techniques in treatment of uretero-pelvic junction obstruction. J Urol 173: 2023
Desai MM, Gill IS (2005) Laparoscopic partial nephrectomy for tumour: current status at the Cleveland Clinic. BJU Int 95 [Suppl 2]: 41–45
Desai MM, Gill IS, Kaouk JH et al. (2003) Laparoscopic partial nephrectomy with suture repair of the pelvicaliceal system. Urology 61: 99–104
Dunn MD, Clayman RV (2000) Laparoscopic management of renal cystic disease. World J Urol 18: 272–277
Eden C, Gianduzzo T, Chang C et al. (2004) Extraperitoneal laparoscopic pyeloplasty for primary and secondary ureteropelvic junction obstruction. J Urol 172: 2308–2311
Fornara P, Doehn C, Seyfarth M, Jocham D (2000) Why is urological laparoscopy minimally invasive? Eur Urol 37: 241–250
Fornara P, Zacharias M, Steinacker M et al. (2003) Laparoscopic vs. open nephrectomy. 10 years‘ results of a nonrandomized comparative study of 549 patients with benign kidney diseases. Urologe A 42: 197–204
Fricke L, Doehn C, Steinhoff J et al. (1998) Treatment of posttransplant hypertension by laparoscopic bilateral nephrectomy? Transplantation 65: 1182–1187
Gill IS (2000) Laparoscopic radical nephrectomy for cancer. Urol Clin North Am 27: 707–719
Gill IS, Matin SF, Desai MM et al. (2003) Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumors in 200 patients. J Urol 170: 64–68
Gill IS, Remer EM, Hasan WA et al. (2005) Renal cryoablation: outcome at 3 years. J Urol 173: 1903–1907
Guazzoni G, Cestari A, Montorsi F et al. (2004) Laparoscopic treatment of adrenal diseases: 10 years on. BJU Int 93: 221–227
Heniford BT, Arca MJ, Walsh RM, Gill IS (1999) Laparoscopic adrenalectomy for cancer. Semin Surg Oncol 16: 293–306
Janetschek G, Abdelmaksoud A, Bagheri F et al. (2004) Laparoscopic partial nephrectomy in cold ischemia: renal artery perfusion. J Urol 171: 68–71
Klingler HC, Remzi M, Janetschek G et al. (2003) Comparison of open versus laparoscopic pyeloplasty techniques in treatment of uretero-pelvic junction obstruction. Eur Urol 44: 340–345
Matin SF (2005) Radical laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma: current status. BJU Int 95 [Suppl 2]: 68–74
Matin SF, Gill IS (2005) Recurrence and survival following laparoscopic radical nephroureterectomy with various forms of bladder cuff control. J Urol 173: 395–400
McDougall EM, Afane JS, Dunn MD et al. (2000) Laparoscopic nephropexy: long-term follow-up – Washington University experience. J Endourol 14: 247–250
McKinlay R, Mastrangelo MJ Jr, Park AE (2003) Laparoscopic adrenalectomy: indications and technique. Curr Surg 60: 145–149
Melchior AM, Steinacker M, Zacharias M, Fornara P (2003) Standardized positioning and trocar placement for laparoscopic interventions in urology. Urologe A 42: 1070–1073
Mimata H, Mizoguchi H, Ohno H et al. (1997) Three approaches for laparoscopic unroofing of simple and complicated renal cysts. Int J Urol 4: 212–217
Moon DA, El-Shazly MA, Chang CM et al. (2006) Laparoscopic pyeloplasty: evolution of a new gold standard. Urology 67: 932–936
Patard JJ, Shvarts O, Lam JS et al. (2004) Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. J Urol 171: 2181–2185
Rassweiler J, Fornara P, Weber M et al. (1998) Laparoscopic nephrectomy: the experience of the laparoscopy working group of the German Urologic Association. J Urol 160: 18–21
Rassweiler JJ, Schulze MM, Marrero R et al. (2004) Laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma: Is it better than open surgery? Eur Urol 46: 690–697
Steinberg JR, Matin SF (2004) Laparoscopic radical nephroureterectomy: dilemma of the distal ureter. Curr Opin Urol 14: 61–65
Suzuki H (2006) Laparoscopic adrenalectomy for adrenal carcinoma and metastases. Curr Opin Urol 16: 47–53
Vallancien G, Cathala N, Cathelineau X, Rozet F (2004) Laparoscopic surgery for renal cancers. Bull Acad Natl Med 188: 39–45
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Jurczok, A., Hamza, A., Nill, A. et al. Stellenwert der laparoskopischen Nierenchirurgie in der Urologie. Urologe 45, 1111–1117 (2006). https://doi.org/10.1007/s00120-006-1157-9
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DOI: https://doi.org/10.1007/s00120-006-1157-9