Department of Urology, Columbia University Medical Center, New York, New York.
We evaluated our contemporary outcomes with laparoscopic partial nephrectomy (LPN) for renal cortical neoplasms (RCN) by an experienced single surgeon in our last 100 consecutive patients.
We reviewed a prospectively established database and identified 378 patients who underwent LPN for RCN. Data from the most recent 100 consecutive patients (June 2007 to August 2009) were evaluated for oncologic, functional, and recovery outcomes, and tumors were stratified by size. There were 57 men and 43 women. The mean tumor size was 2.8 cm (range 0.9-9.0 cm).
The mean operative time was 132 minutes (range 95-350 minutes) and the mean blood loss was 175 mL (range 25-1000 mL). There were 13 (13%) complications. Seventy-seven tumors were ≤ 4 cm (group 1) and 23 tumors were >4 cm (group 2). The groups were similar in terms of demographics, perioperative data, and complications. The mean warm ischemia time in groups 1 and 2 were 25.9 and 29.5 minutes, respectively (P=.04). Overall, 79% of the tumors were malignant renal cell carcinoma variants with a positive margin rate of 2%. With a median follow-up of 8 months, there was 1 local recurrence. The median change between preoperative estimated glomerular filtration rate and 3 months' follow-up estimated glomerular filtration rate was 10.1 mL per minute per 1.73 m(2) (P>.001).
LPN is a safe and effective treatment option for RCN. With extensive experience and a well-developed surgical technique, patient outcomes are improved and postoperative complications are reduced. LPN may be applied to more complex cases including larger and hilar tumors.
Written by:
Mues AC, Okhunov Z, Haramis G, Landman J. Are you the author?
Reference: J Laparoendosc Adv Surg Tech A. 2011 Apr 12. Epub ahead of print.
doi: 10.1089/lap.2010.0411
PubMed Abstract
PMID: 21486150
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