[Laparoscopic surgery for renal cancers].
327 patients with renal adenocarcinoma underwent laparoscopic radical nephrectomy (n=123), radical open nephrectomy (n=113), laparoscopic partialnephrectomy (n=47) or partial open nephrectomy (n=20) for stage T1 disease. Eighteen patients underwent open radical nephrectomy and six laparoscopic radical nephrectomy for stage T2 and T3 disease. Median tumor size was 9.6 cm after open surgery and 4.1 cm after laparoscopic surgery (p<0.01). Intraoperative blood loss was 254 ml during laparoscopy and 460 ml during open surgery (p<0.01). The hospital stay lasted 4.5 days after laparoscopic surgery and 10 days after open surgery (p<0.01). Complications were the same in the two groups, affecting 21.5 and 27.5% of patients, respectively (NS). Oncological results: stage for stage, the results were identical in the open and laparoscopic groups. The specific actuarial recurrence-free survival rate at 5 years among patients with stage PT1 disease was 97% after open radical nephrectomy and 96.8% after laparoscopic surgery; the corresponding rates were 100% after partial open surgery and 100% after laparoscopic partial surgery. Thus, laparoscopic surgery for renal adenocarcinoma offers identical oncological results to open surgery for patients with non metastatic tumors measuring less than 7 cm. Partial laparoscopic surgery offers the same results as partial open nephrectomy.
Vallancien
Guy
G
Institut Montsouris, Département d'Urologie, 42 Bd Jourdan 75014 Paris.
Cathala
Nathalie
N
Cathelineau
Xavier
X
Rozet
François
F
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications; D016896:Treatment Outcome
La chirurgie coelioscopique des cancers du rein.