Current affiliation: Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC, USA
Laparoscopic partial nephrectomy for multiple tumours: feasibility and analysis of peri-operative outcomes
Article first published online: 24 DEC 2010
© 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL
Volume 108, Issue 8, pages 1330–1334, October 2011
How to Cite
Tsivian, A., Tsivian, M., Benjamin, S. and Sidi, A. A. (2011), Laparoscopic partial nephrectomy for multiple tumours: feasibility and analysis of peri-operative outcomes. BJU International, 108: 1330–1334. doi: 10.1111/j.1464-410X.2010.09995.x
- Issue published online: 29 SEP 2011
- Article first published online: 24 DEC 2010
- Accepted for publication 8 October 2010
- renal cell carcinoma;
- partial nephrectomy
Study Type – Therapy (case series)
Level of Evidence 4
What’s known on the subject? and What does the study add?
Laparoscopic nephron-sparing procedures have been increasingly utilized. However, in the presence of multiple tumours the procedure choice is usually shifted to radical nephrectomy.
In view of favourable perioperative outcomes, the benefits of minimally-invasive, nephron-sparing surgery in experienced hands could be safely extended to patients presenting with multiple ipsilateral renal masses.
- • To describe our experience with laparoscopic partial nephrectomy (LPN) for multiple kidney tumours and compare the outcomes with LPN performed for single masses.
PATIENTS AND METHODS
- • Retrospective analysis of medical records of patients undergoing LPN at our institution between 2005 and 2009 was performed.
- • The cohort was divided in two groups based on tumour focality: group 1, LPN for a single tumour (n= 99) and group 2, LPN for multiple ipsilateral tumours (n= 12).
- • The groups were compared with regards to demographic and peri-operative variables.
- • Demographic variables were not different between the groups. Median dominant tumour size was 3.1 cm (interquartile range [IQR] 2.4–4.0) and 4.0 cm (2.3–5.9) in groups 1 and 2, respectively.
- • Median secondary tumour size in group 2 was 1.0 cm (1.0–1.8).
- • Operative times were longer in group 2 compared with group 1 (220 vs 160 min, P= 0.009).
- • Warm ischaemia times (WIT) (23 vs 22 min) and estimated blood loss (EBL) (100 vs 85 mL) were similar.
- • LPN is a viable option for the treatment of multiple ipsilateral renal tumours.
- • Peri-operative outcomes are similar to standard LPN with the exception of longer operative time.
- • In experienced hands, the advantages of minimally invasive surgery may be extended to select patients with ipsilateral multifocal renal tumours.