Enucleación laparoscópica de masas renales
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v82i3.816Palabras clave:
Cáncer Renal, Nefrectomía, Laparoscopia, Período PerioperatorioResumen
Introducción: La enucleación tumoral (ET) de las masas renales como alternativa de cirugía conservadora de nefronas se ha incrementado en los últimos años.
Objetivos: Describir los resultados perioperatorios, oncológicos y funcionales de la ET laparoscópica en una serie de pacientes con masas renales.
Material y método: Estudio descriptivo y retrospectivo en 71 pacientes operados de ET laparoscópica por masa renal, en el Centro Nacional de Cirugía de Mínimo Acceso, La Habana, 2010-2019. Se consideraron variables clínicas-epidemiológicas, perioperatorias, las complicaciones, grado Clavien-Dindo y variables oncológicas. Se empleó el programa SPSS versión 23.0. Se calcularon frecuencias, porcentajes medias, desviación estándar y el t student (p<0.05). Para la supervivencia se empleó curva de Kaplan Meier.
Resultados: la edad media fue 58 años. Predominaron los pacientes masculinos (60.6%), con comorbilidades (87.3%), el diagnóstico incidental (73.2%), los tumores de baja complejidad (64.8%). La media del tamaño tumoral y del RENAL score fue 33.6 mm y 6.1, respectivamente. Se empleó abordaje transperitoneal con mano-asistencia en (92.9%), el sangrado medio fue 335.9 ml y la estancia 5.2 días. La función renal postoperatoria se conservó (p=0.082). Predominaron las complicaciones postoperatorias (14.1%) y el sangrado (8.4%) y las grado II y IV (4.2%, respectivamente). La mayoría de las masas fueron malignas (71.8%), predominó el CRcc (52.1%), los pT1a (78.4%), la supervivencia global fue 100% y CE 96,0%. El tiempo medio de seguimiento de 7.4 años.
Conclusiones: La ET laparoscópica es una alternativa de tratamiento factible para el tratamiento de masas renales seleccionadas, con resultados perioperatorios, oncológicos y funcionales satisfactorios.
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