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Retrospective comparison of laparoscopic partial nephrectomy versus laparoscopic renal cryoablation for small (<3.5
Georgios Haramis1, Joseph A Graversen, Adam C Mues
1Department of Urology, Columbia University Medical Center, New York, New York, USA.
Objective:
We compared perioperative and short-term outcomes of renal laparoscopic partial nephrectomy (LPN) and laparoscopic cryoablation (LCA) in patients with small (<3.5 cm) renal cortical neoplasms.
Methods:
A retrospective analysis from our prospectively established database was performed. We identified 92 patients with 95 lesions treated with LPN and 75 patients with 91 lesions treated with LCA.
Results:
The LPN and LCA groups were comparable in mean tumor size and preoperative and postoperative creatinine level (P=.495, P=.953, and P=.101) respectively. Patients undergoing LPN were younger in age (58.8 versus 69.2 years, P<.001), had a higher mean estimated blood loss (168.4 versus 6 mL, P=.005), and had a prolonged mean operative time (151.6 versus 128.6 minutes, P=.01). Six complications occurred in the LCA group and 11 in the LPN group. The median follow-up time was 21.8 months for LPN and 14 months for LCA (P<.001). Two recurrences were detected in the LCA group, and 1 recurrence was reported after LPN.
Conclusions:
In the treatment of small renal cortical neoplasms with short-term follow-up, LPN and LCA seem to be equally effective. LCA offers decreased blood loss, shorter operative time, and less morbidity. Longer follow-up is required to establish oncologic efficacy.
