To compare the results of laparoscopic and open partial nephrectomy.
From February 2000 to June 2016, 178 patients (mean age 58.2 years) with stage T1 kidney tumors underwent partial nephrectomy. This cohort included 106 (59.5%) men and 72 (40.5%) women. Open partial nephrectomy was performed in 102 (57.3%) patients (group 1) and laparoscopic partial nephrectomy (LPL) - 76 (42.7%, 2nd group). The majority (92.2%) of patients underwent resection for elective and 14 (7.8%) for absolute indications. Preoperatively, 163 (91.6%) and 15 (8.4%) patients had stage T1a stage T1b, respectively. The tumor size ranged from 2.4 to 6.2 cm and from 2 cm to 5.4 cm in group 1 and 2, respectively. A comparative analysis included operative time, warm ischemia time, blood loss, duration of drainage and the length of hospital stay.
Open partial nephrectomy was associated with shorter operative time (105 min versus 125 min) and warm ischemia time (14.5 vs. 20.8 min) compared with laparoscopic partial nephrectomy. Laparoscopic partial nephrectomy was characterized by a smaller blood loss (180 ml vs. 365 ml, p<0.05) and a shorter length of hospital stay (2.5 days vs. 5.6 days, p<0.05). One patient from each group was found to have positive surgical margins.
Currently, laparoscopic partial nephrectomy is the method of choice for stage T1 kidney tumors. Despite the comparatively longer operative time and warm ischemia time, laparoscopic partial nephrectomy leads to faster patient recovery and fewer complications.
Urologiia (Moscow, Russia : 1999). 2017 Dec [Epub]
B K Komyakov, B G Guliev, A I Novikov, Kh Kh Yagubov
Department of Urology, I.I. Mechnikov North-Western State Medical University, Saint-Petersburg, Russia.