Laparoscopic nephrectomy for XXXX : evaluation of efficacy and safety: a multicenter experience.

@entity1 @entity1358 @entity5 @entity3
OBJECTIVES: Although laparoscopic radical nephrectomy is a safe and minimally invasive alternative to open surgery, the long-term disease-free outcome of this procedure has not been reported. We evaluated our experience with the laparoscopic management of @entity1358 to assess the clinical efficacy of this surgical modality. METHODS: Between February 1991 and June 1997, 157 @entity1 at five institutions were retrospectively identified who had clinically localized, pathologically confirmed, @entity1358 and had undergone laparoscopic radical nephrectomy. Operative and clinical records were reviewed to determine morbidity, disease-free status, and @entity5 -specific survival. Of the @entity1 followed up for at least 12 months (n = 101), 75% had an abdominal computed tomography scan at their last visit. RESULTS: The mean age at surgery was 61 years (range 27 to 92) and all @entity1 were clinical Stage T1-2,NO,MO. Fifteen @entity1 (9.6%) had perioperative complications. During a mean follow-up of 19.2 months (range 1 to 72; 51 @entity1 with 2 years or more of follow-up), no @entity1 developed a laparoscopic port site or renal fossa @entity5 recurrence. Four @entity1 developed @entity3 , and 1 @entity1 developed a local recurrence. The 5-year actuarial disease-free rate was 91%+/-4.8 (SE). At last follow-up, there were no @entity5 -specific mortalities. CONCLUSIONS: The laparoscopic surgical management of @entity1358 is feasible. Short-term results indicate that laparoscopic radical nephrectomy is not associated with an increased risk of port site or retroperitoneal recurrence. Longer follow-up is necessary to compare long-term survival and disease-free rates with those of open surgery.
