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Interfascial planes as surgical landmarks for laparoscopic upper retroperitoneal surgery: a cadaveric and retrospectively clinical study.
Huang, Jiayu; Zhang, Tianyou; Mo, Jiahui; Ye, Lei; Zhong, Wenwen; Xu, Dazheng; Song, Zhenzhu; Liu, Jihua; Liu, Dongliang; Tao, Yiran; Wang, Dejuan; Qiu, Jianguang.
Afiliación
  • Huang J; Department of Urology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • Zhang T; Department of Urology, Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • Mo J; Department of Urology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • Ye L; Department of Urology, Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • Zhong W; Department of Urology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • Xu D; Department of Urology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • Song Z; Department of Urology, Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • Liu J; Department of Urology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • Liu D; Department of Urology, Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • Tao Y; Laboratory of Anatomy, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
  • Wang D; Traffic Police Detachment of Guangzhou Public Security Bureau, Guangzhou, China.
  • Qiu J; Traffic Police Detachment of Guangzhou Public Security Bureau, Guangzhou, China.
Transl Androl Urol ; 13(5): 720-735, 2024 May 31.
Article en En | MEDLINE | ID: mdl-38855604
ABSTRACT

Background:

Radiologists currently accept the concept of "interfascial plane (IFP)" to understand retroperitoneal anatomy, replacing Meyers' classic tricompartmental theory. Despite much research on retroperitoneal anatomy, its anatomical structure, embryonic origin and developmental process still require further exploration to guide the optimization of surgical process. This study aims to explore the anatomical basis of IFP related to laparoscopic upper retroperitoneal surgery (LURS) and to compare the clinical outcomes of trans-interfascial plane procedures for LURS (TIFP-LURS) with conventional LURS (Con-LURS).

Methods:

The study consisted of two parts cadaveric and clinical study. The cadaveric study involved dissecting and observing the retroperitoneal fasciae and IFP in 32 cadavers using gross anatomical and histological methods. This retrospective clinical study compared the perioperative data and complications of 229 patients who underwent TIFP-LURS and 121 patients who underwent Con-LURS for upper retroperitoneal lesions at our center.

Results:

The cadaveric study revealed that the retroperitoneal space was composed of multilaminar fasciae that formed potential bloodless spaces among them, that could be used as surgical landmarks and operating planes. The clinical study showed that TIFP-LURS had a significantly less estimated blood loss, lower intraoperative complication rate, lower postoperative complication rate, shorter hospital-stay and lower long-term postoperative complications rate than Con-LURS. Multivariate analysis indicated that the TIFP procedure was an independent protective factor for decreasing the risk of postoperative complications.

Conclusions:

The IFP are potential avascular spaces that can be used during laparoscopic surgery, and TIFP-LURS is a novel surgical approach that can improve the safety and efficacy of laparoscopic surgery for upper retroperitoneal lesions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Transl Androl Urol Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: China
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Transl Androl Urol Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: China