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Comparison between laparoscopic partial nephrectomy and laparoscopic ablation therapy: a meta-analysis.

Cheng-Qiang Mo1, Zhou Yu, Wu-Lin Tan

  • 1Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University , Guangzhou , China.

Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy
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Summary

Laparoscopic ablation therapy (LAT) offers better peri-operative outcomes for small renal masses (SRMs) than laparoscopic partial nephrectomy (LPN). However, LAT has a higher local recurrence rate and no clear advantage in preserving renal function.

Keywords:
Laparoscopicablation therapypartial nephrectomysmall renal masses

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Area of Science:

  • Urology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Small renal masses (SRMs) are increasingly detected, necessitating effective treatment options.
  • Laparoscopic partial nephrectomy (LPN) and laparoscopic ablation therapy (LAT) are minimally invasive approaches for SRM management.
  • Comparative data on peri-operative and oncological outcomes between LPN and LAT are crucial for clinical decision-making.

Purpose of the Study:

  • To perform a meta-analysis comparing peri-operative and oncological outcomes of LPN versus LAT for SRMs.
  • To evaluate the efficacy and safety of these two surgical techniques in treating small renal masses.

Main Methods:

  • A systematic literature search was conducted across multiple databases (MEDLINE, EMBASE, Google Scholar, Cochrane Library, CNKI).
  • Included were clinical trials comparing LPN and LAT for SRMs.
  • Data on peri-operative and follow-up outcomes were extracted, and statistical analyses, including publication bias and sensitivity analyses, were performed.

Main Results:

  • Eleven studies with 928 patients (525 LPN, 403 LAT) were analyzed.
  • LPN was associated with greater blood loss, longer operative time, and extended hospital stay.
  • LAT demonstrated a significantly higher local recurrence rate, while no significant difference in postoperative renal function was observed between the groups.

Conclusions:

  • LAT offers superior peri-operative results compared to LPN for SRMs.
  • The higher local recurrence rate with LAT warrants careful consideration.
  • LAT does not appear to provide a distinct advantage in renal function preservation, and further randomized trials with long-term follow-up are recommended.