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Laparoscopic Retroperitoneal Enucleation-Separation Surgery for Renal Angiomyolipoma: Perioperative and Oncologic
Wentao Liu1, Lin Qi1, Minfeng Chen1
1Department of Urology, Xiangya Hospital, Central South University , Changsha, P.R. China .
Objective:
To report a novel technique of laparoscopic retroperitoneal enucleation-separation surgery for specifically located renal angiomyolipoma (RAML) treated in our institute.
Patients And Methods:
We prospectively analyzed 40 patients who were randomized and received laparoscopic simple enucleation (Group 1) or enucleation-separation (Group 2) from January 2011 to February 2013. Patient characteristics, perioperative outcomes, renal function, and oncologic outcomes were compared between the groups.
Results:
Average age, body mass index, sex distribution, tumor location and size, and operative time showed no significant difference between the two groups (p > 0.05). Average warm ischemia time in Group 1 was longer than that in Group 2 (25.3 minutes vs 17.6 minutes, p = 0.001). No complications except for one postoperative hemorrhage that occurred in Group 1 were observed. An improved early affected renal function recovery was observed in the Group 2 (percentage of glomerular filtration rate reduction for Group 1 vs Group 2, 24.3% vs 18.3%; p = 0.001). No local recurrences were found during the follow-up period.
Conclusion:
Laparoscopic simple enucleation and enucleation-separation technique are safe, efficient, and minimally invasive therapies for selected patients with RAMLs. In addition, the enucleation-separation appears to significantly minimize the warm ischemia injury and results in superior short-term renal function preservation, which could be a nephron-sparing alternative for the treatments of RAMLs.
