Laparoscopic partial nephrectomy: beyond the straightforward T1a

BJU International
Alexander TsivianA Ami Sidi

Abstract

What's known on the subject? and What does the study add? Complex tumour features (e.g. size, hilar location, multifocality) are generally considered contraindicative for LPN and only a handful of studies reporting encouraging outcomes with more complex tumours. Herein we suggest that in experience hands the benefits of minimally-invasive surgery may be safely extended to patients with more complex renal masses. To report on our experience in extending the indications for LPN beyond the single, T1a renal mass assessing the perioperative outcomes in a comparative fashion. Retrospective review of consecutive patients undergoing LPN for a renal mass in an academic centre between 2005-2010. 150 patients were divided into two groups based on tumours characteristics: straightforward T1a (group 1: single, <4 cm, n = 84) and complex (group 2: multiple and/or hilar and/or ≥4 cm, n = 66). Comparison of demographic, clinical, radiographic and perioperative outcomes (operative times, blood loss, warm ischemia times, intra- and postoperative complications). In group 2, 19 tumours were hilar, 15 were multifocal and 44 measured ≥4 cm; 2 of these criteria were present in 7, and all three in 3 cases. Warm ischemia times and blood loss were comp...Continue Reading

References

Aug 11, 2004·Urology·Andrew P SteinbergInderbir S Gill
May 11, 2005·Urology·Karen ReisigerJaime Landman
May 12, 2007·European Urology·Alexander TsivianA Ami Sidi
Oct 22, 2008·The Journal of Urology·Craig G RogersPeter A Pinto
Aug 18, 2009·The Journal of Urology·Steven C CampbellUNKNOWN Practice Guidelines Committee of the American Urological Association
Nov 6, 2009·BJU International·Sergey ShikanovArieh L Shalhav
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Jul 17, 2010·European Urology·Börje LjungbergUNKNOWN European Association of Urology Guideline Group

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Citations

Sep 12, 2013·Journal of Endourology·Simpa Samuel SalamiLouis Raphael Kavoussi
Aug 3, 2013·Current Opinion in Urology·Alessandro VolpeAlexandre Mottrie
Aug 10, 2017·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Matvey TsivianAlexander Tsivian
May 27, 2014·American Society of Clinical Oncology Educational Book·Dae Y KimJose A Karam

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