Aim: To evaluate the safety of en bloc stapler ligation of the renal vascular pedicle during laparoscopic radical nephrectomy for renal cell carcinoma.
Subjects and methods: Clinical data were collected prospectively from 70 patients who underwent either en bloc stapling of the renal hilum (n=35) (Group A) or the separate ligation method (n=35) (Group B) to treat renal cell carcinoma. To evaluate the incidence of arteriovenous fistula (AVF), blood pressure and heart rate were measured, and abdominal auscultation was performed at 1 month, 3 months, 6 months, and 12 months post-surgery. Abdominal computed tomography was also performed at 6 and 12 months post-surgery. In addition, preoperative characteristics and postoperative outcomes (such as operation time and estimated blood loss [EBL]) were examined.
Results: Both operation time and EBL were lower for Group A: operative time, Group A versus Group B, 60.26±10.94 minutes versus 67.51±10.49 minutes (P=.007); EBL, Group A versus Group B, 33.53±13.46 mL versus 49.14±32.21 mL (P=.011). No statistically significant differences were noted in either of the postoperative variables (blood pressure and heart rate), and there was no clinical evidence of bruit or AVF at 12 months post-surgery.
Conclusions: No AVF was observed after en bloc ligation upon clinical follow-up or on radiological evaluation.