ANAHEIM, CA (UroToday.com) - Dr Lane presented a large comparative study between open (OPN) and laparoscopic partial nephrectomies (LPN) from the Mayo Clinic (OPN), Johns Hopkins (LPN) and the Cleveland Clinic (LPN & OPN). The data was collected both retrospectively and prospectively from tumor registries. Only solitary tumors <7cm were included. Compared with patients undergoing LPN (n=771), the patients undergoing OPN (n=1029) were higher risk patients with a higher percentage of patients presenting with symptoms, with reduced performance status, impaired renal function, and a tumor in a solitary kidney. Multivariate analysis revealed that LPN had shorter operative times (201 vs 222 min), reduced blood loss, and shorter hospital stays. There was no difference in intraoperative complications. LPN had longer warm ischemia times, more postoperative complications, and more subsequent procedures.

The mean tumor size and positive margin rate was 2.7 cm and 3.5 cm and 2.9% and 1.3% for LPN and OPN respectively. Renal function at 3 months was similar. Median follow-up was 1.2 yrs and 2.8 years for the LPN and OPN respectively. Kaplan-Meier predictive three-year cancer-specific survival was 99.3% and 99.2% for LPN and OPN, respectively. This large comparative review has shown that LPN was associated with additional postoperative morbidity compared to OPN; however, equivalent functional and early oncologic outcomes were achieved.

Authors:Brian Lane, Inderbir Gill, Louis Kavoussi, Micheal Blute, Denise Babineau, Jose Colombo Jr, Igor Frank, Sompol Permpongkosol, Christopher Weight, Michael Kattan, Andrew Novick.

AUA 2007 ABST[495] - Comparison of 1800 Laparoscopic and Open Partial Nephrectomies for Single Renal Tumors

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