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[Comparative study of laparoscopic partial nephrectomy and traditional open procedure: analysis of 26 cases]
Tong-Wen Ou1, Yi Zhang, Xin Cui
1Department of Urology, Xuanwu Hospital Affiliated to Capital Medical University, Beijing 100053, China. outongwen@sohu.com.
Objective:
To evaluate the feasibility and technique points of laparoscopic partial nephrectomy in the treatment of malignant renal tumor.
Methods:
26 patients with malignant renal tumor underwent partial nephrectomy over the past 5 years, including 11 cases treated with laparoscopic partial nephrectomy, with the mean tumor size of 2.4 cm (1.6 - 4.2 cm), and 15 cases treated with traditional open procedure, with the mean tumor size of 2.6 cm (1.8 - 3.1 cm). The surgical techniques of the laparoscopic partial nephrectomy included laparoscopic clamp control of the renal hilum in order to allow cold knife excision of the mass, with laparoscopic repair of the collecting system. The operative time, blood loss, warm ischemia time, perioperative complications, fluid intake time, and convalescence were evaluated and compared.
Results:
Laparoscopic procedures were successful conducted in the 11 patients without necessity to converse to open surgery. The operative time of the traditional open procedure group was (92 +/- 36) min, significantly shorter than that of the laparoscopic partial nephrectomy group [(138 +/- 97) min, P < 0.05]. The mean blood loss of the traditional open procedure group was (150 +/- 68) ml, not significantly different from that of the laparoscopic partial nephrectomy group [(176 +/- 88) ml, P > 0.05]. The warm ischemia time of the laparoscopic partial nephrectomy group was (12 +/- 5) min, significantly shorter than that of the traditional open procedure [(25 +/- 18) min, P < 0.05]. The fluid intake time after operation of the laparoscopic partial nephrectomy group was (16 +/- 6) hours, significantly shorter that of traditional open procedure group [(31 +/- 7) hours, P < 0.05]. The post-operative hospital stay time of the laparoscopic partial nephrectomy group was (7.0 +/- 2.4) days, significantly shorter than that of the traditional open procedure group [(12.0 +/- 4.5) days, P < 0.05].
Conclusion:
Laparoscopic partial nephrectomy is a feasible and safe method for malignant renal tumors. This procedure has the advantages of minimal invasion, less complications and shorter convalescence time. In order to obtain ideal operative outcome, en bloc control of the renal hilum, cold knife excision of the mass, and reliable renal parenchymal repair with suture are recommended.
