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Laparoscopic partial nephrectomy for technically challenging tumours.

Sergey Shikanov1, David A Lifshitz, Tom Deklaj

  • 1Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois, USA. sergeyshikanov@gmail.com

BJU International
|November 6, 2009
PubMed
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Laparoscopic partial nephrectomy (LPN) is safe for challenging kidney tumors, even those near the hilum or posterior upper pole. While these cases required more collecting system repair, overall surgical and recovery outcomes were similar to less complex LPN procedures.

Area of Science:

  • Urology
  • Surgical Oncology

Background:

  • Laparoscopic partial nephrectomy (LPN) is a standard treatment for renal tumors.
  • Tumors located near the hilum, at the posterior upper pole, or endophytic present technical challenges during LPN.

Purpose of the Study:

  • To evaluate the outcomes of LPN for technically challenging renal tumors compared to those in standard locations.

Main Methods:

  • A prospective case series included 184 patients undergoing LPN between 2002 and 2008.
  • Patients were divided into two groups: technically challenging tumors (group 1) and others (group 2).
  • Statistical analysis used t-tests, rank-sum tests, chi-square, and exact tests (P < 0.05).

Main Results:

  • Group 1 (challenging tumors) had a higher rate of collecting system repair (78% vs. 61%, P = 0.03).

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  • Operative outcomes (surgery time, ischemia time, blood loss, complications) were similar between groups.
  • Postoperative outcomes (renal function, complications, hospital stay, margin rates) were also similar.

    • Conclusions:

    • Laparoscopic partial nephrectomy (LPN) is a safe and effective option for well-selected patients with technically challenging renal tumors.
    • Surgical experience can mitigate the complexities associated with these difficult tumor locations.