Results And Follow-up Of Laparoscopic And Open Partial Nephrectomy In Local Renal Cell Carcinoma

Objective:To compare the results of laparoscopic partial nephrectomy (LPN) to open partial nephrectomy (OPN) in the treatment of local renal cell carcinoma.Methods:We retrospectively analysed the records of 57 cases of partial nephrectomy in our hospital from October 2006 to September 2010,including 27 cases of laparoscopic partial nephrectomy and 30 cases of open partial nephrectomy.Of the 27 cases in LPN,17 were male and 10 were female,with an average age of 52.57 years.The diameter of the tumors was 1.2～5.0cm,mean 2.55cm.Of the 30 cases in OPN,18 were male and 12 were female,with an average age of 53.0 years.The diameter of the tumors was 1.6～5.0cm, mean 3.03cm.Variables compared included age,diameter of the tumor,gender,kidney location,clinical symptom,neoplasm staging,surgical indication,tumor location,operation time,warm ischemia time,blood loss,amount and time of drainage,time of anus exsufflation,postoperative hospital stay,creatinine levels before and after partial nephrectomy.To design the postoperative table and use the letter or telephone follow-up the patients.Results:There were no significant difference between the two groups with age,diameter of the tumor,gender,kidney location,clinical symptom,neoplasm staging,surgical indication,tumor location,amount and time of drainage(P>0.05).LPN group was obviously better than OPN group in the blood loss,time of anus exsufflation,postoperative hospital stay(P<0.05);but in the operation time,warm ischemia time,OPN group was obviously better than LPN group(P<0.01).The creatinine levels after operation were increased in both of LPN and OPN groups,there were significantly in the paired-samples T test(P=0.000<0.001).The complication in the laparoscopic group was more than the open surgery group.In the laparoscopic group,l case turn to open partial nephrectomy,because operative hemorrhage.Pathological result confirmed all the patient:45 cases clear cell carcinoma,6 cases papillary renal cell carcinoma,5 cases chromophobe adenoma and 1 case multiple cyst renal cell carcinoma.At the end of the follow up,no patients treated with NSS had died,none of them tumour related.Conclusion:Though the laparoscopic approach is associated with longer operation time,longer warm renal ischemia time,and more postoperative complications, but laparoscopic partial nephrectomy for the treatment of localized renal tumor has the advantages of minimal invasion and efficiency.Further efforts need to be made to facilitate technique, improving surgical experience.Laparoscopic partial nephrectomy will be an important method in the treatment of renal cell carcinoma in future.