Outcomes of retroperitoneal laparoscopic partial nephrectomy in patients with endophytic renal tumors

Abstract

Objective To compare the perioperative outcomes and postoperative complications of retroperitoneal laparoscopic partial nephrectomy (RLPN) for the treatment of endophytic renal tumors and non-endophytic tumors. Methods Three hundred and ninety-two patients who underwent RLPN for kidney neoplasms from May 2005 to September 2012 were retrospectively analyzed. They were divided into endophytic renal tumor group (48 cases) and non-endophytic tumor group (344 cases). There were no significant differences in the aspects of gender, age, body mass index, tumor side, diameter, preoperative estimated glomerular filtration rate (eGFR) between the two groups. Operative time, warm ischemia time, method of renal vascular occlusion, repair rate of renal collecting system, estimated blood loss, usage of laparoscopic ultrasonography, intraoperative complications, pathological types, postoperative hospitalization days, postoperative complications and postoperative eGFR were collected and analyzed. Results Patients with endophytic tumors had significantly more usage of laparoscopic ultrasonography (95.8% versus 1.2%, P 0.05) between the 2 groups. All the patients' surgical margins were negative. The rates of postoperative complication (Clavien grade Ⅰ to Ⅲb) were 4.2% and 2.9% in the endophytic group and non-endophytic group, respectively (P>0.05). Median follow-up was 42 (33-108) months in endophytic group and 45 (33-120) months in non-endophytic group. No local recurrence or metastasis occurred in the two groups. Conclusions In experienced hands, RLPN could represent a feasible, safe and effective treatment for selected patients diagnosed with endophytic renal tumors.Laparoscopic ultrasonography is valuable on locating the tumor and defining tumor margins in RLPN of endophytic renal tumors. Key words: Laparoscopes; Partial nephrectomy; Kidney neoplasms; Retroperitoneal