Minimally invasive partial nephrectomy for single versus multiple renal tumors

Area of Science:

• Urology
• Minimally Invasive Surgery
• Oncology

Background:

• Partial nephrectomy is the standard for small renal masses.
• Managing multiple ipsilateral renal tumors presents unique surgical challenges.
• Robotic and laparoscopic approaches offer potential benefits in complex renal surgeries.

Purpose of the Study:

• To compare perioperative outcomes of robotic/laparoscopic partial nephrectomy for multiple renal tumors versus single renal tumors.
• To evaluate the safety and efficacy of treating multiple renal tumors in a single operative session.

Main Methods:

• Retrospective review of a prospectively maintained database (2001-2010).
• Matched-pair analysis comparing 33 patients with multiple tumors to 33 patients with a single tumor.
• Matching criteria included dominant tumor size, patient age, and baseline estimated glomerular filtration rate.

Main Results:

• Operative time and hospital stay were longer for the multiple tumor group (300 vs. 217 minutes, p=0.002; 3 vs. 1 days, p=0.005).
• Estimated blood loss and warm ischemia time were similar between groups.
• Complication rates (33% vs. 21%) and post-discharge renal function were comparable.

Conclusions:

• Robotic/laparoscopic partial nephrectomy is a safe and feasible option for multiple ipsilateral renal tumors.
• Perioperative outcomes are similar to those for single renal tumors, supporting its use in selected patients.