Should laparoscopy be the standard approach used for radical nephrectomy?

Portis, Andrew J.; Clayman, Ralph V.

doi:10.1007/s11934-001-0014-z

Cited by 14 publications

(1 citation statement)

References 35 publications

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“…Proponents of minimally invasive surgery have argued that patients experience significant QOL benefits with these approaches compared with traditional open approaches 25 . Clinical studies have shown clear benefits in regard to earlier return to activities, resumption of oral intake, and other peri-operative outcomes with minimally invasive surgery 5, 11 .…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Assessment of Quality of Life and Psychosocial Adjustment in Patients With Renal Tumors Undergoing Open, Laparoscopic and Nephron Sparing Surgery

et al. 2012

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Purpose We prospectively evaluated the general and cancer-specific quality of life (QOL) and psychosocial adjustment of patients with a renal mass who underwent radical versus partial nephrectomy performed by laparoscopic or open approaches. Materials and Methods 172 patients with renal tumors completed questionnaires before surgery and again at 3 weeks, 2, 3, 6, and 12 months post-surgery. We assessed general QOL (SF-36), cancer-specific-QOL (CARES-SF), intrusive thoughts and avoidance behaviors, and fear of recurrence. We used mixed model regression analyses to compare these measures across surgery types over the course of the study and adjusted for tumor size, histology, stage and renal function. Results The physical component score of the SF-36 different significantly by surgery type over time (p = 0.04). Patients who had laparoscopy improved by month 2 whereas those who had open surgery had poorer QOL until month 3. Better cancer-specific QOL was reported in patients undergoing radical versus partial nephrectomy. Age also had significant effects on outcomes. Conclusions We report on one of the most comprehensive patient-reported prospective QOL studies in RCC patients. There were significant differences in QOL and psychosocial adjustment outcomes over the course of one year among patients who had one of four commonly accepted surgical renal procedures, and we show that these outcomes must be evaluated in the context of tumor characteristics, cancer-specific outcomes and renal function. These QOL issues may be important to consider when choosing surgical procedures for patients with renal tumors.

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Section: Discussionmentioning

confidence: 99%