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• W2059580950 abstract "No AccessJournal of UrologyAdult Urology: Outcomes/Epidemiology/Socioeconomics1 May 2005EXPLORING THE LEARNING CURVE, PATHOLOGICAL OUTCOMES AND PERIOPERATIVE MORBIDITY OF LAPAROSCOPIC PARTIAL NEPHRECTOMY PERFORMED FOR RENAL MASS RICHARD E. LINK, SAM B. BHAYANI, MOHAMMED E. ALLAF, IOANNIS VARKARAKIS, TAKESHI INAGAKI, CRAIG ROGERS, LI-MING SU, THOMAS W. JARRETT, and LOUIS R. KAVOUSSI RICHARD E. LINKRICHARD E. LINK More articles by this author , SAM B. BHAYANISAM B. BHAYANI More articles by this author , MOHAMMED E. ALLAFMOHAMMED E. ALLAF More articles by this author , IOANNIS VARKARAKISIOANNIS VARKARAKIS More articles by this author , TAKESHI INAGAKITAKESHI INAGAKI More articles by this author , CRAIG ROGERSCRAIG ROGERS More articles by this author , LI-MING SULI-MING SU More articles by this author , THOMAS W. JARRETTTHOMAS W. JARRETT More articles by this author , and LOUIS R. KAVOUSSILOUIS R. KAVOUSSI More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000154777.24753.1bAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigated the learning curve, pathological results and perioperative morbidity of laparoscopic partial nephrectomy (LPN). Materials and Methods: The records of all LPN cases at our institution between January 1999 and March 2004 were reviewed. Of 223 cases 217 (97.3%) were performed for an enhancing renal mass. Results: Mean tumor size was 2.6 cm (range 1 to 10) and 95.4% of patients had a normal contralateral kidney. Transient vascular control was performed in 75.1% of cases. Mean operative time (186 minutes) decreased with surgeon experience (p = 0.003) but was independent of tumor size (p = 0.964). Mean warm ischemia time (27.6 minutes) depended on tumor size (p = 0.005) but not on experience (0.964). Mean blood loss was 385 cc and the perioperative transfusion rate was 6.9%. Postoperative complications occurred in 23 cases (10.6%) with the most common being ileus (1.8%), bleeding (1.8%) and urinary leakage (1.4%). Although the mean serum creatinine change after LPN was a function of tumor size (p <0.001), it was clinically insignificant (0.13 mg/dl). No significant relationship was observed between warm ischemia time and creatinine change (p = 0.262). The final pathological evaluation revealed renal cell carcinoma in 144 patients (66.4%) and the overall positive margin rate was 3.5%. Only 2 renal cell carcinoma recurrences in the operated kidney (1.4%) were identified (mean followup ± SD 24 ± 12 months). Conclusions: LPN is an effective approach for treating small renal masses with low perioperative morbidity. Contrary to previous reports, more than 30% of the enhancing renal lesions excised in this series were found to be benign on final pathological evaluation. 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1-Jun-2016.Tabayoyong W, Abouassaly R, Kiechle J, Cherullo E, Meropol N, Shah N, Dong S, Thompson R, Smaldone M, Zhu H, Ialacci S and Kim S (2018) Variation in Surgical Margin Status by Surgical Approach among Patients Undergoing Partial Nephrectomy for Small Renal MassesJournal of Urology, VOL. 194, NO. 6, (1548-1553), Online publication date: 1-Dec-2015.Khalifeh A, Autorino R, Hillyer S, Laydner H, Eyraud R, Panumatrassamee K, Long J and Kaouk J (2018) Comparative Outcomes and Assessment of Trifecta in 500 Robotic and Laparoscopic Partial Nephrectomy Cases: A Single Surgeon ExperienceJournal of Urology, VOL. 189, NO. 4, (1236-1242), Online publication date: 1-Apr-2013.Patel H, Mullins J, Pierorazio P, Jayram G, Cohen J, Matlaga B and Allaf M (2018) Trends in Renal Surgery: Robotic Technology is Associated with Increased Use of Partial NephrectomyJournal of Urology, VOL. 189, NO. 4, (1229-1235), Online publication date: 1-Apr-2013.Ellison J, Montgomery J, Wolf J, Hafez K, Miller D and Weizer A (2018) A Matched Comparison of Perioperative Outcomes of a Single Laparoscopic Surgeon Versus a Multisurgeon Robot-Assisted Cohort for Partial NephrectomyJournal of Urology, VOL. 188, NO. 1, (45-50), Online publication date: 1-Jul-2012.Crane N, Gillern S, Tajkarimi K, Levin I, Pinto P and Elster E (2018) Visual Enhancement of Laparoscopic Partial Nephrectomy With 3-Charge Coupled Device Camera: Assessing Intraoperative Tissue Perfusion and Vascular Anatomy by Visible Hemoglobin Spectral ResponseJournal of Urology, VOL. 184, NO. 4, (1279-1285), Online publication date: 1-Oct-2010.Benway B, Bhayani S, Rogers C, Dulabon L, Patel M, Lipkin M, Wang A and Stifelman M (2018) Robot Assisted Partial Nephrectomy Versus Laparoscopic Partial Nephrectomy for Renal Tumors: A Multi-Institutional Analysis of Perioperative OutcomesJournal of Urology, VOL. 182, NO. 3, (866-873), Online publication date: 1-Sep-2009.Nguyen M and Gill I (2018) Halving Ischemia Time During Laparoscopic Partial NephrectomyJournal of Urology, VOL. 179, NO. 2, (627-632), Online publication date: 1-Feb-2008.Turna B, Frota R, Kamoi K, Lin Y, Aron M, Desai M, Kaouk J and Gill I (2018) Risk Factor Analysis of Postoperative Complications in Laparoscopic Partial NephrectomyJournal of Urology, VOL. 179, NO. 4, (1289-1295), Online publication date: 1-Apr-2008.Pyo P, Chen A and Grasso M (2018) Retroperitoneal Laparoscopic Partial Nephrectomy: Surgical Experience and OutcomesJournal of Urology, VOL. 180, NO. 4, (1279-1283), Online publication date: 1-Oct-2008.Simmons M and Gill I (2018) Decreased Complications of Contemporary Laparoscopic Partial Nephrectomy: Use of a Standardized Reporting SystemJournal of Urology, VOL. 177, NO. 6, (2067-2073), Online publication date: 1-Jun-2007.Gill I, Kavoussi L, Lane B, Blute M, Babineau D, Colombo J, Frank I, Permpongkosol S, Weight C, Kaouk J, Kattan M and Novick A (2018) Comparison of 1,800 Laparoscopic and Open Partial Nephrectomies for Single Renal 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Patients—Evolution of the Surgical Technique and its Impact on Patient OutcomesJournal of Urology, VOL. 178, NO. 2, (435-439), Online publication date: 1-Aug-2007.Pavlovich C (2018) Editorial CommentJournal of Urology, VOL. 178, NO. 2, (416-417), Online publication date: 1-Aug-2007.Miller D, Taub D, Dunn R, Wei J and Hollenbeck B (2018) Laparoscopy for Renal Cell Carcinoma: Diffusion Versus Regionalization?Journal of Urology, VOL. 176, NO. 3, (1102-1107), Online publication date: 1-Sep-2006.Permpongkosol S, Bagga H, Romero F, Sroka M, Jarrett T and Kavoussi L (2018) Laparoscopic Versus Open Partial Nephrectomy for the Treatment of Pathological T1N0M0 Renal Cell Carcinoma: A 5-Year Survival RateJournal of Urology, VOL. 176, NO. 5, (1984-1989), Online publication date: 1-Nov-2006.Permpongkosol S, Colombo J, Gill I and Kavoussi L (2018) Positive Surgical Parenchymal Margin After Laparoscopic Partial Nephrectomy for Renal Cell Carcinoma: Oncological OutcomesJournal of Urology, VOL. 176, NO. 6, (2401-2404), Online publication date: 1-Dec-2006. Volume 173Issue 5May 2005Page: 1690-1694 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordscarcinoma, renal cellkidneylaparoscopynephrectomyMetricsAuthor Information RICHARD E. LINK More articles by this author SAM B. BHAYANI More articles by this author MOHAMMED E. ALLAF More articles by this author IOANNIS VARKARAKIS More articles by this author TAKESHI INAGAKI More articles by this author CRAIG ROGERS More articles by this author LI-MING SU More articles by this author THOMAS W. JARRETT More articles by this author LOUIS R. KAVOUSSI More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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