Multicenter experience with nonischemic multiport laparoscopic and laparoendoscopic single-site partial nephrectomy...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Oncology

Background:

• Partial nephrectomy is the gold standard for small renal masses.
• Minimally invasive techniques like laparoscopic partial nephrectomy (LPN) offer advantages over open surgery.
• Non-ischemic techniques aim to improve renal function preservation during LPN.

Purpose of the Study:

• To assess the feasibility and safety of non-ischemic laparoscopic partial nephrectomy (NI-LPN) using a bipolar radiofrequency coagulator.
• To compare outcomes between multiport and laparoendoscopic single-site (LESS) NI-LPN.
• To evaluate the short-term preservation of renal function after NI-LPN.

Main Methods:

• A multicenter retrospective review of 60 patients undergoing NI-LPN between April 2006 and September 2009.
• Patients underwent either multiport or LESS NI-LPN, utilizing a Habib 4X bipolar radiofrequency coagulator for hemostasis.
• Tumor excision and renorrhaphy were performed following hemostasis, with analysis of demographics, tumor characteristics, and perioperative outcomes.

Main Results:

• 98.3% of patients (59/60) successfully underwent NI-LPN.
• Mean operative time was 160 minutes, with a mean estimated blood loss of 131.4 mL.
• No significant differences in demographics, tumor size, outcomes, or complications were observed between multiport and LESS approaches. Renal function was preserved (preoperative/postoperative creatinine 1.02/1.07, P = .471).

Conclusions:

• Non-ischemic multiport and LESS partial nephrectomy are safe and effective procedures.
• The technique demonstrates excellent short-term preservation of renal function.
• Long-term oncological efficacy requires further investigation.