Early Experience of Laparoscopic Partial Nephrectomy for Renal Tumor / 대한비뇨기과학회지

ABSTRACT

PURPOSE: To evaluate the feasibility of laparoscopic partial nephrectomy for patients with renal tumors from our early experiences. MATERIALS AND METHODS: Between February 2004 and February 2006, 20 patients with renal tumors underwent a laparoscopic partial nephrectomy, and of these, 15 were enrolled in our study. The mean age and body mass index of 6 male and 9 female were 55.2 years and 23.9, respectively. The mean tumor size was 4.2 cm. The operation was performed with a 4 trocar system through a transperitoneal approach. Bleeding from the renal parenchyme was controlled using sutures, argon beam coagulation, fibrin glue and cellulose meshes. RESULTS: The laparoscopic partial nephrectomies were successfully performed in all patients. The mean operative time and transfusion rate were 180.7 minutes and 60%, respectively. In 6 patients, vascular bulldog clamps were used to remove the tumor mass, with a mean warm ischemic time of 32.5 minutes. The initiation of the postoperative oral intake and ambulation were 1.6 and 2.7 days, respectively, with a mean hospital stay of 8.8 days. Complications were detected in 2 patients, one case each of urinary leakage and an incisional hernia. Pathological examinations revealed renal cell carcinomas with negative surgical margins in 9 patients and angiomyolipomas in a further 6. There was no recurrence during the mean follow-up of 11.4 months. CONCLUSIONS: A laparoscopic partial nephrectomy for a renal tumor can be safely performed. Although excellent perioperative outcomes were observed, long-term follow-up is still necessary to confirm theist effect on cancer control.