Retroperitoneal Laparoscopic Partial Nephrectomy Versus Radical Nephrectomy for Clinical T1 Renal Hilar Tumor: Comparison of Perioperative Characteristics and Short-Term Functional and Oncologic Outcomes.
PURPOSE
To present our single-center experience with retroperitoneal laparoscopic partial nephrectomy (LPN) and retroperitoneal laparoscopic radical nephrectomy (LRN) for T1 renal hilar tumors and evaluate which one is better.


METHODS
A retrospective review of 63 patients with hilar tumors undergoing retroperitoneal LPN or LRN was performed. The perioperative characteristics, change in estimated glomerular filtration rate (eGFR) from baseline to month 3, and oncologic outcomes were summarized.


RESULTS
In total, 25 patients underwent LPN, and 38 patients underwent LRN. The mean tumor size in the LPN and LRN groups was 4.5 and 4.9 cm, respectively. The mean operation time was longer in the LPN group than that in the LRN group (212.5 minutes versus 160.7 minutes, respectively; P < .05). Patients undergoing the LPN had a longer median length of hospital stay after surgery (9 days versus 7 days, P < .05). Four percent of patients in the LPN group experienced postoperative complications compared with 5% of patients in the LRN group, which was not significantly different. Compared with preoperative eGFR, postoperative eGFR at 3 months decreased by 15.2 mL/min/1.73 m2 and 27.8 mL/min/1.73 m2 in the LPN and the LRN groups, respectively (P < .05). There was one local recurrence in the LPN group and three local or distant recurrences in the LRN group (P > .05).


CONCLUSIONS
In experienced hands, although retroperitoneal LRN can result in shorter operation times and shorter lengths of stay, retroperitoneal LPN can preserve renal function better than LRN. Retroperitoneal LPN should be the priority in selected patients with T1 renal hilar tumors, especially for patients with renal insufficiency.
['Yang|Chuance|C|', 'Wang|Zhenlong|Z|', 'Huang|Shanlong|S|', 'Xue|Li|L|', 'Fu|Delai|D|', 'Chong|Tie|T|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002292:Carcinoma, Renal Cell D061887:Conversion to Open Surgery D005260:Female D005919:Glomerular Filtration Rate D006801:Humans D007680:Kidney Neoplasms D010535:Laparoscopy D007902:Length of Stay D008297:Male D008875:Middle Aged D009364:Neoplasm Recurrence, Local D009392:Nephrectomy D061646:Operative Time D011183:Postoperative Complications D012189:Retrospective Studies D016896:Treatment Outcome
laparoscopic partial nephrectomy hilar tumor laparoscopic radical nephrectomy retroperitoneal approach