Thulium Laser-Assisted Versus Conventional Laparoscopic Partial Nephrectomy for the Small Renal Mass

Area of Science:

• Urology
• Minimally Invasive Surgery
• Oncology

Background:

• Laparoscopic partial nephrectomy (LPN) is a standard minimally invasive treatment for small renal masses (SRMs).
• Laser-assisted LPN (LLPN) utilizes lasers for hemostasis, potentially enabling surgery without renal artery clamping.
• This study compares 2-μm continuous thulium LLPN with conventional LPN (CLPN).

Purpose of the Study:

• To evaluate the technical feasibility and clinical outcomes of 2-μm continuous thulium LLPN.
• To compare LLPN with conventional LPN (CLPN) in patients with SRMs.
• To assess oncological, functional, and quality of life outcomes between LLPN and CLPN.

Main Methods:

• Retrospective analysis of 312 patients with SRMs undergoing minimally invasive nephron-sparing surgery.
• Matched pair analysis comparing 36 LLPN patients with 36 CLPN patients.
• Review of surgical data, complications, pathological variables, oncological, functional, and HRQoL outcomes.

Main Results:

• LLPN group had significantly shorter warm ischemia time (WIT) (0 vs. 12.4 minutes) and decreased operative time (84.1 vs. 95.5 minutes).
• LLPN group had longer tumor resection time (9.5 vs. 2.2 minutes).
• Complication rates, renal function, local recurrence, recurrence-free survival, and SF-36 scores were similar between LLPN and CLPN groups.

Conclusions:

• Both LLPN and CLPN demonstrate similar oncological and functional outcomes for select patients with SRMs.
• LLPN offers advantages such as zero WIT and reduced operative time.
• Both techniques are viable minimally invasive treatment options for SRMs.