Elective laparoscopic partial nephrectomy in patients with tumors >4 cm.

Academic Article

Abstract

  • OBJECTIVES: To assess the perioperative outcomes of elective laparoscopic partial nephrectomy to treat renal tumors in patients with tumor burdens > 4 cm compared with those with tumor burdens of < or = 4 cm. METHODS: A retrospective review of medical records was performed for all patients who had undergone laparoscopic partial nephrectomy for renal tumors from January 2000 to March 2005. The preoperative risk factors (ie, sex, age, American Society for Anesthesiologists score), perioperative course (ie, operative time, estimated blood loss, warm ischemia time, intraoperative and postoperative complications, transfusion rate, intraoperative biopsy of surgical margins, length of hospitalization), and pathologic outcomes (ie, tumor stage, type, and grade) were collected and compared between the patients in the 2 cohorts. RESULTS: Patients with larger tumors had significantly more complications (37.0% vs 21.8%, P = .039) and a significantly longer hospitalization (4.1 vs 3.0 days, P = .026). For those with malignant tumors > 4 cm compared with those with malignant tumors of < or = 4 cm, the complication rate was 33.3% and 11.6% (P = 0.006) and the length of hospitalization was 4.5 and 3.2 days (P = .055), respectively. No other differences were noted between the 2 groups stratified by tumor size. CONCLUSIONS: Laparoscopic partial nephrectomy is an oncologically feasible option for tumor burdens > 4 cm in the greatest dimension to provide a nephron-sparing option for patients in whom individually selected lesions can be isolated.
  • Published In

  • Urology  Journal
  • Keywords

  • Age Factors, Aged, Female, Humans, Kidney Neoplasms, Laparoscopy, Male, Medical Oncology, Middle Aged, Nephrectomy, Postoperative Complications, Retrospective Studies, Treatment Outcome, Urology
  • Digital Object Identifier (doi)

    Author List

  • Rais-Bahrami S; Romero FR; Lima GC; Kohanim S; Permpongkosol S; Trock BJ; Jarrett TW; Kavoussi LR
  • Start Page

  • 580
  • End Page

  • 583
  • Volume

  • 72
  • Issue

  • 3