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Laparoscopic partial nephrectomy: An experience in 227 cases.

O A Castillo1, G López-Fontana2, I Vidal-Mora2

  • 1Departamento de Urología y Centro de Cirugía Robótica, Clínica Indisa, Santiago, Chile; Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile.

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|October 12, 2013
PubMed
Summary
This summary is machine-generated.

Laparoscopic partial nephrectomy (LPN) is a safe and effective treatment for kidney tumors, offering outcomes comparable to open surgery. This minimally invasive approach demonstrates low complication rates and excellent long-term oncologic control.

Keywords:
Carcinoma renalCirugía conservadora de nefronasLaparoscopiaLaparoscopic surgeryNefrectomía parcialNephron-sparing surgeryPartial nephrectomyRenal cell carcinoma

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Oncology

Background:

  • Partial nephrectomy is the gold standard for small renal masses.
  • Laparoscopic partial nephrectomy (LPN) offers a minimally invasive alternative to open surgery.
  • Evaluating long-term outcomes of LPN is crucial for establishing its efficacy.

Purpose of the Study:

  • To assess the long-term experience and outcomes of laparoscopic partial nephrectomy (LPN).
  • To review existing literature on LPN for comparison.
  • To determine the safety and oncologic effectiveness of LPN.

Main Methods:

  • Retrospective chart review of 227 consecutive LPN procedures.
  • Data collection included perioperative details, clinical outcomes, and oncologic results.
  • Procedures were performed between June 1995 and June 2010.

Main Results:

  • The study included 227 patients with a mean age of 56.4 years, predominantly with T1a tumors (90.74%).
  • Mean operative time was 108.42 minutes, with a median warm ischemia time of 25 minutes.
  • Low complication rates were observed: intraoperative 2.64%, postoperative 5.72%. No mortality or conversion to open surgery was reported. Positive margins occurred in 2.7% of cases with no local recurrence.
  • Clear cell carcinoma was the most common histology (74.6%). Mean follow-up was 27 months, with one case of port site and peritoneal recurrence.

Conclusions:

  • Laparoscopic partial nephrectomy (LPN) is a safe and viable alternative to open partial nephrectomy.
  • LPN provides equivalent oncologic outcomes compared to the traditional open approach.
  • Experienced centers can achieve comparable morbidity rates with LPN.