title: Laparoscopic radical nephrectomy for T1 renal cancer: the gold standard? A comparison of laparoscopic vs open nephrectomy.
abstract: OBJECTIVE
  To evaluate the complication rate and clinical follow-up of patients treated for T1 renal cancer by open or laparoscopic nephrectomy at the same institution, as this approach appears to be attractive for treating small renal cancers.
  
  
  METHODS
  Between 1995 and 2002, 39 patients underwent retroperitoneal laparoscopic and 26 transperitoneal open radical nephrectomy for T1 renal cancer (TNM 1997). Variables before during and after surgery, e.g. cancer recurrence, were compared between the groups.
  
  
  RESULTS
  There were no differences between the laparoscopic and open groups in age, sex ratio, weight, height, fitness score, operative duration (134 vs 133 min), minor or major complications, tumour diameter, Fuhrman grade or length of follow-up. Patients who underwent laparoscopic surgery had less blood loss (133 vs 357 mL, P < 0.001), less need for transfusion (none vs 150 mL, P = 0.04), a lower consumption of analgesia drugs, and shorter hospitalization (5.5 vs 8.8 days, P < 0.001). With a mean follow-up of 20.4 months there was no recurrence or tumour progression.
  
  
  CONCLUSIONS
  Laparoscopic radical nephrectomy for patients with T1 renal cancer is a safe, reliable procedure that decreases hospitalization time and bleeding, and ensures the same cancer control as open nephrectomy.
authors.affiliation: Department of Urology, CHU Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France.
authors.forename: B
authors.initials: B
authors.lastname: Makhoul
authors.forename: A
authors.initials: A
authors.lastname: De La Taille
authors.forename: D
authors.initials: D
authors.lastname: Vordos
authors.forename: L
authors.initials: L
authors.lastname: Salomon
authors.forename: P
authors.initials: P
authors.lastname: Sebe
authors.forename: J F
authors.initials: JF
authors.lastname: Audet
authors.forename: L
authors.initials: L
authors.lastname: Ruiz
authors.forename: A
authors.initials: A
authors.lastname: Hoznek
authors.forename: P
authors.initials: P
authors.lastname: Antiphon
authors.forename: A
authors.initials: A
authors.lastname: Cicco
authors.forename: R
authors.initials: R
authors.lastname: Yiou
authors.forename: D
authors.initials: D
authors.lastname: Chopin
authors.forename: C C
authors.initials: CC
authors.lastname: Abbou
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods* / Q000592:standards; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods* / Q000592:standards; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome