Laparoscopic partial nephrectomy in patients with neoplasia in a solitary kidney.
OBJECTIVE
To assess the renal function and describe our operative experience with laparoscopic partial nephrectomy (LPN) in patients with solitary kidneys.


METHODS
The medical records were analyzed to find patients with a solitary kidney and renal neoplasms who underwent LPN. Demographic, operative, pathologic, and follow-up data were obtained.


RESULTS
Four patients were identified with solitary kidneys who had undergone LPN. The mean operative time was 251 minutes, mean warm ischemic time 15 minutes, mean estimated blood loss 395 mL, and mean hospitalization stay 3 days. The mean preoperative creatinine was 1.5 mg/dL and the mean peak creatinine 2.0 mg/dL. All patients returned to their baseline creatinine levels in the follow-up period. The final pathologic finding was Stage pT1 in 1, pT3a in 2, and angiomyolipoma in 1 patient. All surgical margins were negative. No cancer recurrence developed in the patients, with a mean follow-up of 17 months (range 3 to 35).


CONCLUSIONS
LPN in patients with a solitary kidney is feasible and a reasonable treatment alternative to open partial nephrectomy.
Bhayani
Sam B
SB
James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Allaf
Mohamad E
ME
Link
Richard E
RE
Rao
Pravin
P
Varkarakis
John M
JM
Jarrett
Thomas W
TW
Kavoussi
Louis R
LR
D016063:Blood Loss, Surgical; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000601:surgery*; D009392:Nephrectomy / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome