Laparoscopic Partial Nephrectomy for T1 XXXX : Comparison of Two Resection Techniques in a Multi-institutional Propensity Score-Matching Analysis.

@entity1 @entity1625 @entity63 @entity5 @entity190 @entity1358
BACKGROUND: Enucleoresection is defined as presence of a minimal paratumor parenchyma that allows for clear visualization of the @entity5 's contours during @entity1625 ( @entity1625 ). Because there is variability in published reports regarding resection techniques during @entity1625 before the surface-intermediate-base (SIB) margin score reporting system, the association between postoperative outcomes and resection techniques are rarely reported. This study was designed to compare the perioperative, oncologic, and functional outcomes between laparoscopic enucleoresection (LER) (SIB score 1  +  1  +  1  =  3) and @entity1625 ( @entity1625 ) (SIB score 1  +  2  +  2  =  5). METHODS: Data from 270 consecutive @entity1 who underwent laparoscopic @entity1625 for single T1 @entity1358 at 3 medical centers were prospectively collected. Propensity score matching was performed on age, gender, body mass index, American Society of Anesthesiologists score, preoperative estimated glomerular filtration rate (eGFR), @entity5 size, RENAL nephrometry score, Charlson score, and solitary kidney status. Normal parenchyma width of each @entity1 was evaluated right after the surgery, and SIB score was assigned retrospectively. Ninety-eight matched @entity1 undergoing LER or @entity1625 were compared for perioperative, oncologic, and functional outcomes. RESULTS: After matching, warm @entity63 time (WIT) and operative time were significantly shorter in LER than @entity1625 group (20.8 vs. 23.8  min, P  =  0.003 and 130.8 vs. 152.1  min, P  =  0.005, respectively). Estimated @entity190 (EBL) also was lower in LER than @entity1625 group (50 vs. 90  mL, P  =  0.045). Complication rates, positive surgical margin rates, and local recurrence rates were comparable between groups (P  =  0.3, P  =  0.62, and P  =  1.0, respectively). At last follow-up, the eGFRs also were comparable in both groups (P  =  0.6). CONCLUSIONS: LER has similar oncologic, functional outcomes and complication rates with the advantage of a shorter WIT, operative time, and lower EBL compared with @entity1625 .
