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- W2000587976 abstract "No AccessJournal of UrologyAdult urology1 Jul 2007Comparison of 1,800 Laparoscopic and Open Partial Nephrectomies for Single Renal Tumors Inderbir S. Gill, Louis R. Kavoussi, Brian R. Lane, Michael L. Blute, Denise Babineau, J. Roberto Colombo, Igor Frank, Sompol Permpongkosol, Christopher J. Weight, Jihad H. Kaouk, Michael W. Kattan, and Andrew C. Novick Inderbir S. GillInderbir S. Gill Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author , Louis R. KavoussiLouis R. Kavoussi Departments of Urology, The Johns Hopkins Hospital, Baltimore, Maryland More articles by this author , Brian R. LaneBrian R. Lane Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author , Michael L. BluteMichael L. Blute Mayo Clinic, Rochester, Minnesota More articles by this author , Denise BabineauDenise Babineau Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio More articles by this author , J. Roberto ColomboJ. Roberto Colombo Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author , Igor FrankIgor Frank Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio Departments of Urology, The Johns Hopkins Hospital, Baltimore, Maryland Mayo Clinic, Rochester, Minnesota More articles by this author , Sompol PermpongkosolSompol Permpongkosol Departments of Urology, The Johns Hopkins Hospital, Baltimore, Maryland More articles by this author , Christopher J. WeightChristopher J. Weight Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author , Jihad H. KaoukJihad H. Kaouk Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio Departments of Urology, The Johns Hopkins Hospital, Baltimore, Maryland Mayo Clinic, Rochester, Minnesota More articles by this author , Michael W. KattanMichael W. Kattan Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio More articles by this author , and Andrew C. NovickAndrew C. Novick Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.03.038AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Laparoscopic partial nephrectomy is an increasingly performed, minimally invasive alternative to open partial nephrectomy. We compared early postoperative outcomes in 1,800 patients undergoing open partial nephrectomy by experienced surgeons with the initial experience with laparoscopic partial nephrectomy in patients with a single renal tumor 7 cm or less. Materials and Methods: Data on 1,800 consecutive open or laparoscopic partial nephrectomies were collected prospectively or retrospectively in tumor registries at 3 large referral centers. Demographic, intraoperative, postoperative and followup data were compared between the 2 groups. Results: Compared to the laparoscopic partial nephrectomy group of 771 patients the 1,028 undergoing open partial nephrectomy were a higher risk group with a greater percent presenting symptomatically with decreased performance status, impaired renal function and tumor in a solitary functioning kidney (p <0.0001). More tumors in the open partial nephrectomy group were more than 4 cm and centrally located and more proved to be malignant (p <0.0001 and 0.0003, respectively). Based on multivariate analysis laparoscopic partial nephrectomy was associated with shorter operative time (p <0.0001), decreased operative blood loss (p <0.0001) and shorter hospital stay (p <0.0001). The chance of intraoperative complications was comparable in the 2 groups. However, laparoscopic partial nephrectomy was associated with longer ischemia time (p <0.0001), more postoperative complications, particularly urological (p <0.0001), and an increased number of subsequent procedures (p <0.0001). Renal functional outcomes were similar 3 months after laparoscopic and open partial nephrectomy with 97.9% and 99.6% of renal units retaining function, respectively. Three-year cancer specific survival for patients with a single cT1N0M0 renal cell carcinoma was 99.3% and 99.2% after laparoscopic and open partial nephrectomy, respectively. Conclusions: Early experience with laparoscopic partial nephrectomy is promising. Laparoscopic partial nephrectomy offered the advantages of less operative time, decreased operative blood loss and a shorter hospital stay. When applied to patients with a single renal tumor 7 cm or less, laparoscopic partial nephrectomy was associated with additional postoperative morbidity compared to open partial nephrectomy. However, equivalent functional and early oncological outcomes were achieved. References 1 : Rising incidence of renal cell cancer in the United States. JAMA1999; 281: 1628. Google Scholar 2 : Cancer statistics, 2005. CA Cancer J Clin2005; 55: 10. Google Scholar 3 : Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent disease. 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Volume 178Issue 1July 2007Page: 41-46 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordslocallaparoscopyrenal cellcarcinomaneoplasm recurrencekidneynephrectomyAcknowledgmentsChristine Lohse, Wei Liao, Mary Federico, Mary Samplaski and Trisha Nemanic assisted with the database, Angela Leschinsky, Kay Lawson Tucker and Diana Baker assisted with followup and Ming Zhou assisted with pathological considerations.MetricsAuthor Information Inderbir S. Gill Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Louis R. Kavoussi Departments of Urology, The Johns Hopkins Hospital, Baltimore, Maryland More articles by this author Brian R. Lane Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Michael L. Blute Mayo Clinic, Rochester, Minnesota More articles by this author Denise Babineau Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio More articles by this author J. Roberto Colombo Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Igor Frank Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio Departments of Urology, The Johns Hopkins Hospital, Baltimore, Maryland Mayo Clinic, Rochester, Minnesota More articles by this author Sompol Permpongkosol Departments of Urology, The Johns Hopkins Hospital, Baltimore, Maryland More articles by this author Christopher J. Weight Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Jihad H. Kaouk Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio Departments of Urology, The Johns Hopkins Hospital, Baltimore, Maryland Mayo Clinic, Rochester, Minnesota More articles by this author Michael W. Kattan Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio More articles by this author Andrew C. Novick Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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- W2000587976 title "Comparison of 1,800 Laparoscopic and Open Partial Nephrectomies for Single Renal Tumors" @default.
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