Retroperitoneal laparoscopic nephron-sparing surgery for renal tumors: report of 32 cases
Xu Zhang1, Hong-Zhao Li, Xin Ma
1Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. xzhang@tjh.tjmu.edu.cn
Objectives:
To evaluate the feasibility and clinical efficacy of retroperitoneal laparoscopic nephron-sparing surgery for renal tumors.
Methods:
Between June 2002 and February 2004, 11 cases of renal benign tumor and 21 cases of renal malignant tumor underwent enucleation of the tumor and wedge resection of the tumor through retroperitoneal laparoscopy, respectively. Tumor resection and hemostasis were mainly achieved by harmonic scalpel. Follow-up studies were performed with an evaluation using renal spiral computed tomography.
Results:
All procedures were technically successful. The mean operating time was 70 minutes for enucleation and 96 minutes for wedge resection. The mean estimated blood loss was 35 mL for enucleation and 65.5 mL for wedge resection. The mean hospital stay after surgery was 6.5 days. No intraoperative complications occurred. The pathologic examination confirmed renal cell carcinoma in 21 patients and angiomyolipoma in 11. The pathologic stage was pT1a in the 21 patients with renal cell carcinoma. All resected tumor specimens had negative surgical margins for cancer. No local recurrence or trocar site metastasis was observed during a mean follow-up period of 13 months.
Conclusions:
Our results indicate that retroperitoneal laparoscopic nephron-sparing surgery represents a feasible option for patients with localized renal tumors. This procedure could offer precise and complete tumor excision while minimizing morbidity, improving cosmesis, and shortening convalescence.
Insights
Retroperitoneal laparoscopic nephron-sparing surgery is a feasible approach for localized renal tumors. This minimally invasive technique allows for precise tumor removal, reduced recovery time, and improved cosmetic outcomes.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Renal tumors require effective treatment while preserving kidney function.
- Nephron-sparing surgery is preferred for localized renal masses.
- Laparoscopic approaches offer potential benefits over open surgery.
Purpose of the Study:
- To assess the feasibility of retroperitoneal laparoscopic nephron-sparing surgery for renal tumors.
- To evaluate the clinical efficacy and outcomes of this minimally invasive technique.
Main Methods:
- Retrospective analysis of 32 patients undergoing retroperitoneal laparoscopic nephron-sparing surgery (June 2002-February 2004).
- Procedures included tumor enucleation or wedge resection using a harmonic scalpel.
- Follow-up included renal spiral computed tomography to assess outcomes.
Main Results:
- All 32 procedures were technically successful with no intraoperative complications.
- Mean operative times were 70 minutes (enucleation) and 96 minutes (wedge resection).
- Mean blood loss was 35 mL (enucleation) and 65.5 mL (wedge resection), with a mean hospital stay of 6.5 days. Pathologic examination confirmed renal cell carcinoma (21 patients) or angiomyolipoma (11 patients), all with negative surgical margins. Mean follow-up of 13 months showed no local recurrence or metastasis.
Conclusions:
- Retroperitoneal laparoscopic nephron-sparing surgery is a feasible and effective option for localized renal tumors.
- The procedure enables precise tumor excision with minimal morbidity.
- Benefits include improved cosmesis and shorter convalescence compared to traditional methods.
