Renal mass anatomic characteristics and perioperative outcomes of laparoscopic partial nephrectomy: a critical analysis

Journal of Endourology
Matvey TsivianAlexander Tsivian

Abstract

Anatomic parameters determining renal mass complexity have been used in a number of proposed scoring systems despite lack of a critical analysis of their independent contributions. We sought to assess the independent contribution of anatomic parameters on perioperative outcomes of laparoscopic partial nephrectomy (LPN). Preoperative imaging studies were reviewed for 147 consecutive patients undergoing LPN for a single renal mass. Renal mass anatomy was recorded: Size, growth pattern (endo-/meso-/exophytic), centrality (central/hilar/peripheral), anterior/posterior, lateral/medial, polar location. Multivariable models were used to determine associations of anatomic parameters with warm ischemia time (WIT), operative time (OT), estimated blood loss (EBL), intra- and postoperative complications, as well as renal function. All models were adjusted for the learning curve and relevant confounders. Median (range) tumor size was 3.3 cm (1.5-11 cm); 52% were central and 14% hilar. While 44% were exophytic, 23% and 33% were mesophytic and endophytic, respectively. Anatomic parameters did not uniformly predict perioperative outcomes. WIT was associated with tumor size (P=0.068), centrality (central, P=0.016; hilar, P=0.073), and endophyti...Continue Reading

References

Jun 13, 2006·Urology·Ramakrishna VenkateshJaime Landman
Nov 13, 2007·European Urology·Francesco PorpigliaRoberto Mario Scarpa
Jul 21, 2009·The Journal of Urology·David A LifshitzArieh L Shalhav
Jul 30, 2009·Annals of Surgery·Pierre A ClavienMasatoshi Makuuchi
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