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Updated: Jun 23, 2026
Single Port Donor Nephrectomy
Published on: March 12, 2011
Laparoscopic partial nephrectomy: the University of Saskatchewan (Regina division) experience
Andrew Tse1, Russel Knaus, Edward Tse
1Health Sciences Student, McMaster University, Hamilton, Ont.
Purpose:
Open partial nephrectomy (OPN) is now the preferred treatment for most T1a and selected T1b tumours. Laparoscopic partial nephrectomy (LPN), created to reduce the morbidity associated with OPN, is now a viable option when performed by experienced laparoscopic surgeons. We retrospectively review our LPN experience and propose a new parameter, the LPN utilization rate (LPN-UR), defined as the probability of any referred patient with a T1 tumour undergoing LPN before the surgeon's knowledge of its imaging characteristics, to define the role of LPN at our institution.
Methods:
Between March 2003 and August 2008, 47 consecutive patients underwent LPN for T1 tumours. All patients underwent transient en bloc vascular occlusion of the renal hilum for cold-scissor tumour excisions. Preoperative, intraoperative, postoperative and pathological data were collected. The LPN-URs for 2005, 2006, 2007 and 2008 were calculated.
Results:
There were 31 nonhilar tumours and 16 hilar tumours. All procedures were completed laparoscopically. Mean tumour size was 3.8 (range 1.5-7.2) cm. Mean operating time was 2.8 (range 1.2-4.5) hours. Mean hospital stay was 5.2 (range 2.0-15.0) days. Mean warm ischemic time (WIT) was 32.7 (range 14.2-50.4) minutes. Six patients (12.8%) received blood transfusions and 1 patient required an emergency nephrectomy for bleeding. One patient developed urinary leakage. One patient developed a late calyceal stricture. Mean postoperative differential renal function was 35%:50%. Median follow-up was 18 months. Pathological examination of all tumours revealed 38/47 (80.9%) malignant tumours with 2 positive surgical margins (4.3%). The LPN-URs for 2005, 2006, 2007 and 2008 were 50%, 54%, 63% and 93%, respectively, for all T1 tumours.
Conclusion:
Laparoscopic partial nephrectomy can be safely performed and used for treatment of most T1 tumours referred to our institution. Long-term follow-up will be required to determine the oncological efficacy of LPN. Every effort should be made to further reduce the WIT. The LPN-UR is a useful parameter for consulting referring physicians and patients.
