Laparoscopic versus Open Partial Nephrectomy for Multilocular Cystic Renal Cell Carcinoma: A Direct Comparison Based on Single-Center Experience

Abstract

Objectives: To compare the treatment of laparoscopic (LPN) versus open partial nephrectomy (OPN) in patients with multilocular cystic renal cell carcinoma (MCRCC). Methods: Thirty-seven patients diagnosed with MCRCC were reviewed retrospectively between January 2007 and January 2013 at our institution. They were divided into two groups: group 1 (LPN) consisted of 19 patients (51.4%) and group 2 (OPN) of 18 patients (48.6%). RENAL and the Preoperative Aspects and Dimensions Used for an Anatomical classification were applied to predict perioperative complications, which were graded based on the Clavien-Dindo classification. Results: The two groups were comparable with regard to all of the patients' baseline characteristics. In group 1, the mean operative time was 142.1 min, including the mean warm ischemia time (WIT) of 32.6 min; the mean estimated blood loss (EBL) was 96.1 ml, the mean retroperitoneal drainage lasted 3.6 days, and the mean postoperative hospital stay was 5.3 days. In group 2, the figures were 126.6 and 23.5 min, 223.3 ml, and 4.6 and 8.7 days, respectively. The differences in WIT, EBL, drainage days and hospitalization were statistically significant between both groups (p < 0.05). No recurrence or new lesions occurred in these patients during a mean follow-up of 37.8 months. Conclusions: Our single-center experience suggests that although it remains technically complex, demanding and challenging for MCRCC, LPN can still induce favorable perioperative results and survival rates in MCRCC are comparable with OPN.

Laparoscopic Versus Open Partial Nephrectomy: A Systemic Review and Meta-Analysis of Surgical, Oncological, and Functional Outcomes

“…The characteristics of the included studies are shown in Supplementary Table 1. All the included studies-6 prospective studies (23)(24)(25)(26)(27)(28) and 20 retrospective studies (22,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)-were cohort observational studies with no randomization. There were 3292 and 4803 patients in the LPN and OPN groups, respectively.…”

Impact of Curative Effect of Laparoscopic and Open Partial Nephrectomy for Complex Renal Tumours on Renal Function

“…Generally, RLPN is characterised as minimally invasive, with a fast recovery time, but has high technical requirements for its operators. 17 One challenge of LPN is to shorten intraoperative WIT as much as possible, to ensure that postoperative residual kidneys maintain good renal function and to reduce the risk of postoperative acute and chronic renal failure. The consensus in the field is that a WIT of 25 minutes is the most appropriate inflection point for shortterm or long-term renal function damage.…”

Pancreatic Fistulae after Urologic Surgery - A Single Centre Experience

“…Clinical symptoms, clinical course and treatment regimen were registered. POPF were classified using the grading system established by the ISGPF [2] and by Clavien-Dindo grading for the classification of postoperative surgical complications [6,7]. A follow-up was done regarding fistula recurrence, malnutrition symptoms or abdominal/retroperitoneal reoperation.…”