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Comparison of Sutureless and Conventional Laparoscopic Partial Nephrectomy: A Propensity Score-Matching Analysis
Feng Zhang1, Shuang Gao2, Yiqiao Zhao1
1Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China.
Frontiers in Oncology
|March 25, 2021
Summary
Sutureless laparoscopic partial nephrectomy (sLPN) offers comparable safety and efficacy to conventional methods. This technique significantly reduces warm ischemia time, preserving more renal parenchyma and protecting kidney function post-surgery.
Area of Science:
- Urology
- Surgical Oncology
- Nephrology
Background:
- Partial nephrectomy is standard for T1 renal tumors, aiming to preserve renal function.
- Conventional laparoscopic partial nephrectomy (cLPN) involves suturing to control bleeding and reconstruct the kidney.
- Sutureless laparoscopic partial nephrectomy (sLPN) aims to simplify the procedure and potentially reduce complications.
Purpose of the Study:
- To compare the functional outcomes, safety, and efficacy of sutureless laparoscopic partial nephrectomy (sLPN) versus conventional laparoscopic partial nephrectomy (cLPN).
- To evaluate the impact of sLPN on operative time, warm ischemia time (WIT), and estimated glomerular filtration rate (eGFR) changes.
- To assess renal function preservation after sLPN compared to cLPN in patients with T1 stage renal tumors.
Main Methods:
- A retrospective review of 379 patients with T1 stage renal tumors undergoing either sLPN or cLPN.
- Propensity score matching (PSM) was used to balance baseline characteristics between the two groups.
- Perioperative outcomes, including operative time (OT) and WIT, and functional outcomes, specifically eGFR changes at 1 week and 6 months post-surgery, were analyzed.
Main Results:
- After PSM, 116 pairs of patients showed no significant differences in preoperative characteristics.
- sLPN group demonstrated significantly shorter operative time (OT) and warm ischemia time (WIT) compared to cLPN (p < 0.001).
- The sLPN group experienced a statistically smaller decrease in eGFR at 1 week (14.3 vs. 7.4, p < 0.001) and 6 months (11.9 vs. 5.0, p < 0.001) post-surgery, indicating better renal function preservation.
Conclusions:
- Sutureless laparoscopic partial nephrectomy (sLPN) is a safe and effective alternative to conventional laparoscopic partial nephrectomy (cLPN).
- sLPN significantly reduces warm ischemia time (WIT), leading to better preservation of renal parenchyma and function.
- The findings suggest sLPN offers advantages in protecting renal function compared to cLPN.
