Abstract
ABSTRACTPurpose:To assess and report the outcomes of laparoscopic partial nephrectomy) LPN) for T2 renal masses.Materials and Methods:Retrospective review of patients undergoing LPN for clinically localized renal masses ≥7cm between the years 2005-2016. Descriptive analyses were generated for demographics, lesion characteristics, perioperative variables (operative time, warm ischemia time (WIT), estimated blood loss (EBL), intra-operative and postoperative complications (IOC and POC) and pathologic variables (pathology, subtype and Fuhrman grade).Results:A total of 27 patients underwent LPN for a T2 renal mass at our institution between 2005 and early 2016 of which 19 were males. The mean age was 66 (52-72). All procedures were transperitoneal with 16 on the right and 11 on the left. Median operative time was 200 minutes (IQR 181-236) and median WIT 19 minutes (IQR 16-23). EBL was 125mL (IQR 75-175). One case was converted to laparoscopic radical nephrectomy due to suspected tumor thrombus in the renal vein. Surgical margins were positive in one renal tumor in a patient with multiple tumors. There was a total of 2 IOC (7.4%) and 3 POC (11%) classified as Clavien grade 3.Conclusions:To our knowledge, this series is the first to describe the outcomes of LPN for cT2 renal masses. In our series, LPN for larger renal masses appears feasible with favorable perioperative outcomes. Additional data are needed to further explore the benefits of minimally invasive surgical approaches to larger renal masses.
Highlights
Laparoscopic partial nephrectomy (LPN) is a valid treatment option for small renal masses (SRM) [1, 2]
Posterior lesions accounted for 53.8% of cases and the upper pole was involved in 53.8% of cases
One case was converted to laparoscopic radical nephrectomy due to suspected tumor thrombus in the renal vein
Summary
This series is the first to describe the outcomes of LPN for cT2 renal masses. LPN for larger renal masses appears feasible with favorable perioperative outcomes. Additional data are needed to further explore the benefits of minimally invasive surgical approaches to larger renal masses. Submitted for publication: December 04, 2016 Accepted after revision: May 29, 2017 Published as Ahead of Print: July 17, 2017
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More From: International braz j urol : official journal of the Brazilian Society of Urology
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