title: [Extended total nephrectomy with laparoscopy in localized renal carcinoma. Report of 25 cases compared with 32 conventional surgical cases].
abstract: OBJECTIVE
  To evaluate the benefits obtained during the learning phase of laparoscopic nephrectomy (LN) for clinical stage cT1 and cT2 renal cancers.
  
  
  METHODS
  We retrospectively compared our first 25 cases of LN (13 right, 12 left) with 32 nephrectomies performed by Conventional Surgery (CS) (17 right, 15 left) between May 2000 and December 2001. The LN group comprised 18 men and 7 women with a mean age of 63.8 years. The CS group comprised 18 men and 14 women with a mean age of 67.7 years. Preoperative, intraoperative, postoperative and histological parameters were compared by analysis of the variance or nonparametric Mann-Whitney U test for quantitative variables and Chi-square test for qualitative data.
  
  
  RESULTS
  Preoperative and histological parameters, blood loss, quantity and duration of analgesics and the complication rate were similar in the two groups. Resection was complete in every case. The mean duration of radical nephrectomy was significantly shorter by CS (p < 0.001). Return of bowel sounds was more rapid (p = 0.002) and patients were discharged from hospital earlier (p = 0.004) after LN.
  
  
  CONCLUSIONS
  Laparoscopic nephrectomy for cancer must be performed by an operator experienced in laparoscopy. During the learning phase, this procedure provided benefits in terms of return of bowel sounds and length of hospital stay, which should encourage teams performing laparoscopy to perform radical nephrectomy by laparoscopy.
authors.affiliation: Service d'Urologie, CHU de Strasbourg, France. herve.lang@chru-strasbourg.fr
authors.forename: Hervé
authors.initials: H
authors.lastname: Lang
authors.forename: Pierre
authors.initials: P
authors.lastname: Gimel
authors.forename: Maël
authors.initials: M
authors.lastname: Martin
authors.forename: Tien
authors.initials: T
authors.lastname: Nguyen Ngoc
authors.forename: Christian
authors.initials: C
authors.lastname: Saussine
authors.forename: Didier
authors.initials: D
authors.lastname: Jacqmin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies