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Hand-assisted laparoscopic partial nephrectomy after 60 cases: comparison with open partial nephrectomy.

William B DeVoe1, Kent W Kercher, William W Hope

  • 1Department of Urology, Carolinas Medical Center, Charlotte, NC 28203, USA.

Surgical Endoscopy
|October 3, 2008
PubMed
Summary
This summary is machine-generated.

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Hand-assisted laparoscopic partial nephrectomy (HALPN) offers improved outcomes for small renal tumors compared to open partial nephrectomy (OPN). HALPN demonstrates reduced blood loss, shorter operative times, and decreased hospital stays, establishing it as a preferred surgical method.

Area of Science:

  • Urology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Partial nephrectomy is the standard surgical treatment for small, localized renal tumors.
  • Increasing incidence of renal cell carcinoma (RCC) and small kidney masses necessitates minimally invasive approaches.
  • This study compares hand-assisted laparoscopic partial nephrectomy (HALPN) with open partial nephrectomy (OPN).

Purpose of the Study:

  • To compare the efficacy and outcomes of HALPN versus OPN for small renal tumors.
  • To evaluate operative time, blood loss, warm ischemia time, and complication rates.
  • To assess positive margin rates and hospital stay duration between the two surgical techniques.

Main Methods:

  • Prospective data collection for HALPN (N=60) and retrospective data for OPN (N=40).

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  • Comparison of demographic and outcome information between the two surgical groups.
  • Statistical significance determined by a p-value < 0.05.

    • Main Results:

    • Similar average tumor size (2.6 cm) in both HALPN and OPN groups.
    • HALPN demonstrated significantly shorter operative times (161 vs 191 min), less blood loss (120 vs 353 cc), and reduced warm ischemia time (27.0 vs 33.0 min).
    • HALPN also showed a shorter hospital stay (4.9 vs 6.9 days) and a lower final positive margin rate (0% vs 5%) compared to OPN.

    Conclusions:

    • Hand-assisted laparoscopic partial nephrectomy (HALPN) is associated with significant advantages over open partial nephrectomy (OPN).
    • These advantages include diminished blood loss, reduced operating time, shorter warm ischemia, lower positive margin rates, and decreased hospital stay.
    • HALPN is established as the standard surgical approach for small, accessible renal tumors at this institution.