Efficacy Of Laparoscopic Partial Nephrectomy Compared With Laparoscopic Radical Nephrectomy For The Treatment Of Stage T₁b Renal Cell Carcinoma

Objective:To compare the clinical efficacy of laparoscopic partial nephrectomy(LP N)through the retroperitoneal approach compared with laparoscopic radical nephre ctomy(LRN)for the treatment of stage Tib renal cell carcinoma.Methods:Retrospective analysis was performed on 49 patients with single stage T1b renal cell carcinoma who were admitted to Department of Urological Surgery,Affiliated Hospital of University from March 2015 to September 2018.Among them,22 underwent LPN,and 27 underwent LRN;the two surgical approaches were compared for mean duration of surgery,intraoperative blood loss,postoperative length of hospital stay,pre-to post-operative serum creatinine ratio,and postoperative complications.Results:1.In LRN group,1 patient had 700ml of intraoperative blood loss,for which 600ml of blood was transfused;the surgery was completed uneventfully for all the rest patients2.There was statistically significant difference(P<0.05)between LPN and LRN groups in pre-to post-operative serum creatinine ratio(21.9%±22.7%vs 38.2%±20.5%).3.One patient in LPN group developed symptoms of respiratory tract infection;no patients in LPN group developed any complications.4.There were no statistically significant differences between the two groups(all P>0.05)in intraoperative blood loss(189.3 ± 148.8ml vs 197.2± 138.0ml),postoperative length of hospital stay(7.5±2.1d vs 6.5±2.3d),length of surgery(118.41 ± 30.68min vs 125.37±42.17min),or drainage tube indwelling time(3.83±0.10d vs 3.35±0.10d)5.Disease relapse or distant metastasis was not observed in either group over the 9-month follow-upConclusion:1.Pre-to post-operative serum creatinine ratio was lower in LPN group than in LRN group,indicating smaller impact of LPN on renal function2.Where possible,LPN could be used in place of LRN for the treatment of stage T1b renal cell carcinoma,as LPN could provide better efficacy than LRN.