Comparison of Video-Assisted Minilaparotomy, Open, and Laparoscopic Partial Nephrectomy for Renal Masses.
10.3349/ymj.2012.53.1.151
- Author:
Hwang Gyun JEON
1
;
Kyung Hwa CHOI
;
Kwang Hyun KIM
;
Koon Ho RHA
;
Seung Choul YANG
;
Woong Kyu HAN
Author Information
1. Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
- Publication Type:Original Article ; Comparative Study
- Keywords:
Partial nephrectomy;
renal cell carcinoma;
video-assisted surgery;
minimally invasive
- MeSH:
Adult;
Aged;
Carcinoma, Renal Cell/mortality/*surgery;
Female;
Humans;
Kidney Neoplasms/mortality/*surgery;
Laparoscopy/instrumentation/*methods;
Laparotomy/instrumentation/*methods;
Male;
Middle Aged;
Nephrectomy/instrumentation/*methods;
Retrospective Studies;
Treatment Outcome;
Video-Assisted Surgery/instrumentation/*methods
- From:Yonsei Medical Journal
2012;53(1):151-157
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Minimally invasive management of small renal tumors has become more common. We compared the results of partial nephrectomy by video-assisted minilaparotomy surgery (VAMS), open, and laparoscopic techniques. MATERIALS AND METHODS: We retrospectively compared clinicopathological, oncological, and functional outcomes in 271 patients who underwent partial nephrectomy for renal tumors at one institution from 1993 to 2007; including 138 by VAMS, 102 by open, and 31 by laparoscopic technique. RESULTS: Mean follow-up was 47.7+/-29.1 months. No statistically significant differences in the three groups were found in tumor size, tumor location, estimated blood loss, complication rate, preoperative glomerular filtration rate (GFR), and GFR at last follow-up. Ischemic time was shorter in the open (26.9 min) and VAMS (29.3 min) groups than in the laparoscopic group (31.0 min, p=0.021). Time to normal diet and hospital stay were shorter in the VAMS (1.8 days and 5.4 days) and laparoscopic (1.8 days and 4.7 days) groups than in the open group (2.4 days and 7.3 days, p=0.036 and p<0.001, respectively). Of 180 patients with cancer, positive surgical margins occurred in 2 of 82 patients (2.4%) in the VAMS group, none of 75 patients in the open group, and 3 of 23 patients (13.0%) in the laparoscopic group (p=0.084). In the VAMS, open, and laparoscopic groups, 5-year disease-free survival was 94.8%, 95.8%, and 90.3% (p=0.485), and 5-year cancer-specific survival was 96.3%, 98.6%, and 100%, respectively (p=0.452). CONCLUSION: Partial nephrectomy using VAMS technique provides surgical, oncologic, and functional outcomes similar to open and laparoscopic techniques.
