Laparoendoscopic single-site radical nephrectomy for large renal masses

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Large (≥ 7 cm) and locally advanced renal tumors present surgical challenges.
• Minimally invasive techniques are increasingly explored for complex oncologic resections.

Purpose of the Study:

• To evaluate the operative experience and short-term outcomes of laparoendoscopic single-site radical nephrectomy (LESS-RN).
• To assess the feasibility of LESS-RN for managing large and/or advanced stage renal masses.

Main Methods:

• Ten patients underwent LESS-radical nephrectomy (RN) for large (≥ 7 cm) and/or locally advanced renal tumors (>T(2)).
• Intraoperative, postoperative, and short-term follow-up data were collected and analyzed.

Main Results:

• Median operative time was 146 minutes with median blood loss of 100 mL.
• No conversions to open or hand-assisted surgery were required. Median hospital stay was 47 hours.
• 60% of patients were alive with no recurrence at 12.3 months median follow-up; 40% had known metastatic disease pre-operatively.

Conclusions:

• LESS-RN for large or advanced renal masses is technically demanding.
• In experienced hands, LESS-RN is a safe and feasible therapeutic option for these challenging tumors.