Functional and oncologic outcomes of bilateral open partial nephrectomy versus bilateral laparoscopic partial...

Area of Science:

• Urology
• Surgical Oncology
• Nephrology

Background:

• Synchronous bilateral kidney tumors necessitate nephron-sparing surgery.
• Comparing open and laparoscopic partial nephrectomy techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare operative data and outcomes between bilateral open partial nephrectomy (BOPN) and bilateral laparoscopic partial nephrectomy (BLPN) for synchronous bilateral kidney tumors.

Main Methods:

• Retrospective review of 114 patients undergoing BOPN or BLPN between 1992 and 2008.
• Comparison of ischemia time, tumor size, renal function (eGFR), and oncologic outcomes.
• Kaplan-Meier analysis for oncologic outcomes.

Main Results:

• BOPN (92 patients) had larger tumors (4.1 vs 2.7 cm) and longer hospital stays (5.6 vs 4.0 days) than BLPN (22 patients).
• BLPN showed a greater percent decrease in eGFR (38% vs 27%) compared to BOPN.
• Equivalent intermediate-term cancer-specific and recurrence-free survival rates were observed.

Conclusions:

• Both BOPN and BLPN provide equivalent intermediate-term oncologic control for bilateral kidney tumors.
• BLPN was associated with a more significant decline in estimated glomerular filtration rate (eGFR).
• Improved laparoscopic techniques and reduced ischemia times are expected to lead to comparable functional outcomes in the future.