Hand-assisted laparoscopic radical nephrectomy: comparison with conventional open radical nephrectomy

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Renal-cell carcinoma (RCC) is a common malignancy.
• Radical nephrectomy is a standard treatment for localized RCC.
• Minimally invasive surgical techniques are increasingly explored to improve patient outcomes.

Purpose of the Study:

• To compare the oncological and recovery outcomes of hand-assisted laparoscopic radical nephrectomy (HALRN) versus open radical nephrectomy (ORN) for T1-T2 RCC.
• To evaluate the safety and efficacy of HALRN as an alternative to ORN.

Main Methods:

• Retrospective review of 130 patients with T1-T2 RCC (maximum diameter < 10 cm).
• Patients underwent either HALRN (n=63) or ORN (n=67).
• Comparison of operative time, blood loss, postoperative recovery metrics, complications, and survival rates.

Main Results:

• HALRN had a significantly longer operative time (273 min) than ORN (189 min).
• HALRN showed significantly faster recovery: earlier walking (1.4 vs 2.2 days), oral intake (1.8 vs 3.3 days), and discharge (7.4 vs 10.2 days).
• No significant differences in recurrence-free or cancer-specific survival rates were observed between the groups.

Conclusions:

• HALRN is an effective and safe treatment option for RCC, offering comparable cancer control to ORN.
• Despite longer operative times, HALRN provides significant benefits in postoperative recovery and represents a less-invasive approach.
• Proper patient selection is key to achieving successful outcomes with HALRN for RCC.