Laparoscopic partial nephrectomy (LPN) for totally intrarenal tumours
Andrei Nadu1, Hanan Goldberg, Marc Lubin
1Division of Laparoscopic Urology, Department of Urology, Rabin Medical Center, Petach Tikva, Israel. nadua@clalit.org.il
BJU International
|June 26, 2013
Summary
Laparoscopic partial nephrectomy (LPN) is feasible for totally intrarenal tumours (TIT). However, TIT have a higher radical nephrectomy rate due to vital kidney structure involvement, requiring careful preoperative discussion.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Totally intrarenal tumours (TIT) present unique surgical challenges.
- Laparoscopic partial nephrectomy (LPN) is a standard treatment for renal tumours.
- Assessing LPN feasibility for TIT is crucial.
Purpose of the Study:
- To evaluate the feasibility and outcomes of LPN for totally intrarenal tumours (TIT).
- To compare LPN outcomes for TIT versus tumours with exophytic components.
Main Methods:
- Retrospective analysis of patients undergoing LPN for TIT.
- Comparison of TIT group with non-TIT LPN cohort.
- Data collected included demographics, tumour characteristics, intraoperative variables (WIT, blood loss, conversion rates), and postoperative outcomes (renal function, complications, margin status).
Main Results:
- LPN was performed in 41 patients with TIT out of 458 LPN cases.
- TIT had a significantly higher radical nephrectomy (RN) rate (9.7% vs 5.3%) compared to the general LPN cohort.
- Intraoperative and postoperative complication rates, open conversion, and positive surgical margin rates were similar between groups.
Conclusions:
- Laparoscopic partial nephrectomy is technically feasible for totally intrarenal tumours.
- Totally intrarenal tumours are associated with a higher rate of radical nephrectomy due to potential involvement of vital kidney structures.
- While feasible, the increased risk of RN for TIT necessitates thorough preoperative patient counseling.
