Analysis of Surgical Results of Laparoscopic Partial Nephrectomy for Endophytic Renal Tumor

Abstract

Laparoscopic partial nephrectomy is commonly used in cases of exophytic, small renal tumors. The aim of our study was to compare the treatment outcomes of laparoscopic partial nephrectomy in patients with endophytic renal tumors with exophytic lesions. Fifty-two patients (31 males; 21 females; mean age, 55.5 years) who had consecutively undergone laparoscopic partial nephrectomy for a renal tumor were the subjects of the study. An outgrowing mass of greater than half the total tumor volume was considered an exophytic tumor with less than half the volume being endophytic on the basis of a CT scan[jen1]. A total of 29 exophytic and 23 endophytic tumors were compared according to patient characteristics and intraoperative and postoperative surgical outcomes. Two cases of exophytic tumors were converted to open partial surgery, and the total kidney was excised in one case of an endophytic tumor. Endophytic tumors were associated with a longer operation time (198.68±54.92 minutes vs 165.15±39.5 minutes, p=0.021) and increased mean blood loss (453.14±48.2 ml vs 270.74±264.57 ml, p=0.049). Both exophytic and endophytic tumors were comparable in terms of warm ischemic time (35.33±13.04 minutes vs 43.55± 15.18 minutes, respectively, p=0.051), hospital stay, duration of fast, and bed rest. Endophytic renal tumors were more likely to take a longer operation time and bleed more in the setting of laparoscopic partial nephrectomy. However, laparoscopic partial excision of endophytic renal tumors was safely performed with reliable warm ischemic times and few complications. Our study showed the role of laparoscopic partial nephrectomy in managing endophytic renal tumors.