OBJECTIVE: To evaluate our long-term experience with laparoscopic partial nephrectomy (LPN) and to review the literature.
MATERIAL AND METHODS: We performed a retrospective chart review, evaluating 227 consecutives laparoscopic partial nephrectomies performed between June 1995 and June 2010. Perioperative were recorded along with clinical a oncological outcomes.
RESULTS: Mean age was 56.4years (18-87) and clinical stages were T1a, T1b and T2 in 90.74% (206/227), 7.48% (17/227) and 1.76% (4/227), respectively. Median blood loss was 250mL (10-1800). The mean operative time was 108.42minutes (30-240) and median warm ischemia time was 25minutes (10-60). The intraoperative complication rate was 2.64% (6/227), 5 (2.2%) secondary to bleeding. The postoperative complication rate was 5.72% (13/227) and bleeding is also the most frequent in 3% (7/227) of the cases. According to the Clavien classification, 1.32% (3/227), 0.88% (2/227) and 3.52% (8/227) were grade I, II and IIIb, respectively. The mean hospital stay was 3.66 days (1-12). Clear cell carcinoma was the most common histological finding in 74.6% (150patients). TNM clasification was T1a, T1b y T2 in 90.74% (206/227), 7.48% (17/227) and 1,76% (4/227), respectively. No conversion or mortality was reported. Positive surgical margins were found in 4 patients (2.7%), with no local recurrence after long-term follow-up. At a mean follow up of 27months, one patient had port site and peritoneal recurrence.
CONCLUSION: Laparoscopic partial nephrectomy is a safe and viable alternative to open partial nephrectomy, providing equivalent oncologic outcomes and comparable morbidity to the traditional approach in experienced centers.
Written by:
Castillo OA, López-Fontana G, Vidal-Mora I, Alemán E, Aranguren G. Are you the author?
Departamento de Urología y Centro de Cirugía Robótica, Clínica Indisa, Santiago, Chile; Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile.
Reference: Actas Urol Esp. 2013 Oct 7. pii: S0210-4806(13)00278-7.
doi: 10.1016/j.acuro.2013.06.005
PubMed Abstract
PMID: 24112845
Article in English, Spanish.
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