Classical Versus Laparoscopic Approach in Retroperitoneal Lesions — Advantages and Limitations

Background: At present, the laparoscopic intervention in retroperitoneal primitive tumors, abscesses, haematomas and retroperitoneal effusions is still a challenge. The purpose of this paper is to identify the differences between laparoscopic and conventional surgical interventions in diseases of the retroperitoneum.
Material and method: The study follows a retrospective analysis of various retroperitoneal interventions performed on 62 patients between 2010–2012 in the Surgery Clinic 1 of Mures County Hospital. We have chosen from the casuistry the cases with tumoral diseases or non-tumoral and divided the patients into two groups: group I who had undergone classic interventions and group II who had undergone laparoscopic procedures. We studied the clinical medical records, surgical protocols and anatomopathological results.
Results: For 2010 we extracted 23 cases (39,2% classical interventions), for 2011-21 patients (31,4% classic) and for 2012 -18 cases (29,4% classical interventions). According to the type of the disease, 30 classical interventions were performed for tumoral formations and 21 interventions for non-tumoral formations. Laparoscopic tumoral cases included three tumors and a retroperitoneal metastasis,while the non-tumoral were represented by 7 urohaematic effusions as a result of percutaneous nephrolithotomy procedures.
Conclusions: Laparoscopic surgery of retroperitoneal lesions is minimally invasive, the postoperative evolution of patients is favorable, without major complications.. Classical intervention of retroperitoneal lesions is indicated in large haematomas, abscesses, and big invasive tumors with vascular factor which does not allow the use of laparoscopic technique.