Laparoscopic partial nephrectomy for large renal masses: results of a European survey

To evaluate the perioperative effectiveness of laparoscopic partial nephrectomy (LPN) for large (4-7 cm) renal masses, with a review of the experience of six European advanced laparoscopic centres.

A survey was planned; data were extracted from each institutional data base to obtain information about patients who had undergone LPN for renal masses larger than 4 cm. Demographic, radiological growth patterns of the tumours and intraoperative data were collected. Post-operative complications and pathological data were also recorded. All data were processed through statistical software.

Data on 63 patients were collected. Radiological tumour size was 4.7 cm (4.1-7), growth pattern was cortical in 33 cases and cortico-medullar in 30 cases. Warm ischemia time (WIT) was 25.7 min in 7.3% cases bleeding occurred intra-operatively, post-operative surgical complications occurred in 14.6% cases. Pathological analyses revealed malignant lesion in 73% and positive margins in 6.5%. Complications and positive margins are more frequent for cortico-medullar lesions.

This survey confirms that LPN for tumours 4-7 cm in size is feasible in experienced hands. WIT and overall complication rate remain questionable points.