腎細胞癌における腹腔鏡的腎部分切除術対根治的腎摘除術の転帰
Zhuoqi Cheng1, Yulong Li1, Zhongbao Zhou1
1Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
Background And Objectives:
This study aimed to compare the outcomes of laparoscopic nephron-sparing surgery (LNSS) and laparoscopic radical nephrectomy (LRN) for treatment of T1 renal cell carcinoma (RCC).
Methods:
A total of 69 T1 RCC were retrospectively analyzed and divided into an LRN group (n = 34) and an LNSS group (n = 35) according to differences in surgical methods.
Results:
The 2 groups were not significantly different in length of surgery, intraoperative blood loss, postoperative drainage tube indwelling time, length of stay, RCC recurrence, RCC distant metastasis rates, RCC-related mortality, complication rate as well as blood urine nitrogen (BUN), serum creatinine (Scr), and glomerular filtration rate (GFR) levels before the surgery (P > .05); at 1, 3, 6, and 12 months after the surgery, BUN and Scr levels in the LNSS group were significantly lower than those in the LRN group, while GFR levels in the LNSS group were significantly higher than those in the LRN group (P < .05). The preoperative WHOQOL-BREF scores in the physiological, psychological, environmental, and social relationship domains showed no significant differences between the LNSS group and LRN group (P > .05). However, at 12 months postoperatively, all scores in the LNSS group were significantly higher than those in the LRN group (P < .05). However, renal function was better preserved in the LNSS group.
Conclusions:
Both LNSS and LRN demonstrated favorable outcomes in terms of surgical safety and short-term tumor control in the laparoscopic treatment of T1 RCC. However, LNSS exhibited a distinct advantage in preserving renal function and enhancing the patients' quality of life.
