Outcomes of retroperitoneal laparoscopic partial nephrectomy in patients with endophytic renal tumors / 中华泌尿外科杂志

ABSTRACT

Objective To compare the perioperative outcomes and postoperative complications of retroperitoneal laparoscopic partial nephrectomy ( RLPN) for the treatment of endophytic renal tumors and non-endophytic tumors.Methods Three hundred and ninety-two patients who underwent RLPN for kidney neoplasms from May 2005 to September 2012 were retrospectively analyzed . They were divided into endophytic renal tumor group ( 48 cases ) and non-endophytic tumor group ( 344 cases ) .There were no significant differences in the aspects of gender , age, body mass index, tumor side, diameter, preoperative estimated glomerular filtration rate (eGFR) between the two groups.Operative time, warm ischemia time, method of renal vascular occlusion , repair rate of renal collecting system , estimated blood loss , usage of laparoscopic ultrasonography , intraoperative complications , pathological types , postoperative hospitalization days, postoperative complications and postoperative eGFR were collected and analyzed .Results Patients with endophytic tumors had significantly more usage of laparoscopic ultrasonography (95.8%versus 1.2%, P0.05) between the 2 groups.All the patients′surgical margins were negative.The rates of postoperative complication ( Clavien gradeⅠtoⅢb) were 4.2%and 2.9%in the endophytic group and non-endophytic group , respectively ( P >0.05 ) . Median follow-up was 42 ( 33 -108 ) months in endophytic group and 45 (33 -120) months in non-endophytic group.No local recurrence or metastasis occurred in the two groups .Conclusions In experienced hands , RLPN could represent a feasible , safe and effective treatment for selected patients diagnosed with endophytic renal tumors .Laparoscopic ultrasonography is valuable on locating the tumor and defining tumor margins in RLPN of endophytic renal tumors .