Retroperitoneal laparoscopic versus open radical nephrectomy in T1 renal cell carcinoma / 中华泌尿外科杂志

ABSTRACT

Objective To compare the clinical outcomes of retroperitoneal laparoscopic and open radical nephrectomy in patients with T1 renal cell carcinoma (RCC). Methods 352 patients under-went radical nephrectomy for T1 RCC, 185 by retroperitoneal laparoscopic radical nephrectomy(group A) and 167 by open radical nephrectomy through an extraperitoneal flank incision(group B). The op-eration time, blood loss during operation, hospital stay and complication after surgery were analyzed and compared. All the cases were followed up for 6-42 months(median, 25 months) and the survival rates were recorded. Results The operation time of group A, B was 55-130(75.6±11.2)min vs. 50-140(68.0±10.6)min(P0.05). Blood loss was 50-1200(110.6±32.3)ml vs. 50-1500 (160.8±38.1)ml(P<0.05). Eight cases of group A and 132 cases of group B took analgesic after surgery(P<0.05). The fasting period was 1-2(1.3±0.5)day vs. 2-5(2.9±1.2)d of group B (P<0.05)ilengthof hospital stay was 3-7(4.6±1.2)d vs. 7-14(8.9±1.6)d(P<0.05). The survival rate was 85.4 % vs. 86.2% (P0.05). Conclusions Compared with open radical nephrec-tomy, retroperitoneal laparoscopic radical nephrectomy is associated with lower blood loss, narcotic requirement and complications, a shorter hospital stay and earlier resumption of routine activities. Retroperitoneal laparoscopic radical nrphrectomy has become a gold standard therapy in T1 renal cell carcinoma.