Safety and Feasibility of Laparoscopic Nephrectomy for Big Tumors (≥ 10 cm): A Retrospective Multicentric Study
Language English Country United States Media print-electronic
Document type Journal Article, Multicenter Study
PubMed
26880025
DOI
10.1016/j.clgc.2016.01.007
PII: S1558-7673(16)30007-6
Knihovny.cz E-resources
- Keywords
- Kidney cancer, Laparoscopy, Nephrectomy, Renal cell carcinoma, Renal failure,
- MeSH
- Operative Time MeSH
- Body Mass Index MeSH
- Laparoscopy MeSH
- Middle Aged MeSH
- Humans MeSH
- Kidney Neoplasms pathology surgery MeSH
- Nephrectomy adverse effects MeSH
- Intraoperative Complications classification epidemiology MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Feasibility Studies MeSH
- Tumor Burden MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
OBJECTIVE: Evaluate the feasibility of laparoscopic nephrectomy for big tumors. MATERIAL AND METHODS: Data from 116 patients were retrospectively collected from 16 tertiary centres. Clinical and operative parameters, tumor characteristics, pre- and postoperative parameters, and renal function before and after surgery were analyzed. RESULTS: Mean age and body mass index were 61 years and 27.8 kg/m(2), respectively. Males represented 63.8% of patients, and 54.4% presented symptoms at diagnosis. Median tumor size was 11 cm, and 75% of the cases were performed by expert surgeons. Median operative time and blood loss were 180 minutes and 200 mL respectively. Conversion to open surgery was necessary in 20.7% of cases. Intraoperative complications related to massive hemorrhage occurred in 16.4% of patients, resulting in open conversion in 62.5%. Major postoperative complications occurred in only 10 patients (8.6%). In univariate analysis, intraoperative complications, age, and blood loss were predictive factors of conversion to open surgery. Positive surgical margins occurred in 6 patients (5.2%). None of them presented a local recurrence. Predictive factors of recurrence or progression were lymph node invasion, metastases, and Furhman grade. CONCLUSION: Laparoscopic nephrectomy for tumors > 10 cm can be performed safely. Complication rate and positive surgical margins are similar to open surgery. In experienced hands, the benefit of a mini invasive surgery remains evident.
Department of Clinical Pharmacology Centre Hospitalier Universitaire Rennes Rennes France
Department of Pathology Centre Hospitalier Universitaire Rennes Rennes France
Department of Urology Centre Hospitalier Universitaire Angers Angers France
Department of Urology Centre Hospitalier Universitaire Bordeaux Bordeaux France
Department of Urology Centre Hospitalier Universitaire Caen Caen France
Department of Urology Centre Hospitalier Universitaire Cochin Paris France
Department of Urology Centre Hospitalier Universitaire Grenoble Grenoble France
Department of Urology Centre Hospitalier Universitaire Henri Mondor Créteil France
Department of Urology Centre Hospitalier Universitaire Kremlin Bicêtre Paris France
Department of Urology Centre Hospitalier Universitaire La Pitié salpétrière Paris France
Department of Urology Centre Hospitalier Universitaire Limoges Limoges France
Department of Urology Centre Hospitalier Universitaire Lyon Sud Lyon France
Department of Urology Centre Hospitalier Universitaire Nantes Nantes France
Department of Urology Centre Hospitalier Universitaire Rennes Rennes France
Department of Urology Ege University Ege Turkey
Department of Urology Pilsen University Pilsen Czech Republic
Department of Urology Samaritan Medical Center Watertown NY
Department of Urology The Netherlands Cancer Institute Amsterdam Netherlands
References provided by Crossref.org
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