Korean J Urol.  2006 Nov;47(11):1144-1148. 10.4111/kju.2006.47.11.1144.

Laparoscopic Radical Nephrectomy: Results and Oncological Outcome

• Choe HS
• Lee JH
• Hong SH
• Hwang TK

• KMID: 2294270
• DOI: http://doi.org/10.4111/kju.2006.47.11.1144

Abstract

Purpose
A laparoscopic radical nephrectomy is known to cause less morbidity than a traditional open radical nephrectomy. In our institution, the laparoscopic approach, with intact specimen removal, has become the standard technique for radical nephrectomies. Herein, we report the results and oncological outcome of the experience of a single center.
Materials and Methods
We reviewed 68 transperitoneal laparoscopic radical nephrectomies, performed for suspected renal cell carcinoma between December 1999 and June 2006. All data were collected from the patient's medical records.
Results
The mean tumor size, surgical time and estimated blood loss were 4.82cm (1.7-14), 228.5 min (120-480) and 409.1cc (32-1,312), respectively. Conversion to open surgery was required in one case due to Endo-GIA malfunction, and conversion to hand-assisted surgery was performed in one case. The histological findings were pT1, pT2 and pT3 in 40 (59.7%), 9 (13.4%) and 18 patients (26.9%), respectively. In one case, the histology confirmed a non-malignant disease. The follow-up period was from 3 to 80 months (median 18). Distant metastasis was observed in 2 cases, but there was no local recurrence or port metastasis.
Conclusions
A laparoscopic radical nephrectomy is a safe and feasible treatment for localized renal cell carcinomas. Longer follow-up and large scale studies are necessary to evaluate the long-term survival and disease- free rates, and confirm the effectiveness of performing a radical laparoscopic nephrectomy.

Keyword

Renal cell carcinoma; Laparoscopy; Nephrectomy

MeSH Terms

Carcinoma, Renal Cell
Conversion to Open Surgery
Follow-Up Studies
Humans
Laparoscopy
Medical Records
Neoplasm Metastasis
Nephrectomy*
Operative Time
Recurrence

Figure

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  Fig. 1 The bar graph shifting during 68 cases. Note: the more experience gathers, the larger the tumor indicates. There are significant differences between the two groups (p=0.037, independent-sample t-test).

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  Fig. 2 Kaplan-Meier curve indicating the proportions free of disease recurrences. The disease-free survival rate is 96.5±2.4% (95% CI). CI: confidence interval.

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