Evolving Approach in Nephron-Sparing Surgery: Has Anything Changed from Open Surgery to Laparoscopy?
Müslüm Ergün1, Süleyman Sağır2, Osman Akyüz1
1Urology, Atlas University Medicine Hospital, 34200 Istanbul, Turkey.
Archivos Espanoles De Urologia
|September 6, 2024
Summary
Laparoscopic nephron-sparing surgery (LNSS) offers comparable outcomes to open nephron-sparing surgery (ONSS) for small renal masses. When considering tumor complexity via nephrometry scores, LNSS demonstrates similar efficacy to ONSS.
Area of Science:
- Urology
- Surgical Oncology
- Nephrology
Background:
- Nephron-sparing surgery (NSS) is the standard for small renal masses.
- Comparative efficacy of open (ONSS) versus laparoscopic (LNSS) approaches requires further elucidation.
Purpose of the Study:
- To compare the efficacy of ONSS and LNSS for small renal masses.
- To provide insights into surgical outcomes based on tumor complexity.
Main Methods:
- Retrospective study of 97 patients undergoing NSS for small renal masses (Jan 2016-Mar 2024).
- Patients categorized into ONSS (n=41) and LNSS (n=56) groups.
- Tumor complexity assessed using R.E.N.A.L. nephrometry, PADUA, and C-index scores.
Main Results:
- Tumor diameters were similar between ONSS and LNSS groups (p=0.061).
- ONSS treated tumors exhibited more adverse morphometric features (p<0.05).
- Nephrometry scores (R.E.N.A.L., PADUA) were significantly higher for ONSS (p<0.05).
- Estimated blood loss, transfusion rates, and hospital stay were comparable between groups.
Conclusions:
- LNSS provides comparable long-term outcomes to ONSS.
- LNSS achieves similar efficacy to ONSS when adjusted for tumor complexity using nephrometry scores.
