title: Long-term outcome of hand-assisted laparoscopic radical nephrectomy for localized stage T1/T2 renal-cell carcinoma.
abstract: OBJECTIVE
  To evaluate the efficacy of hand-assisted laparoscopic radical nephrectomy (HALRN) in patients with localized stage T(1)/T(2) renal-cell carcinoma, we analyzed the clinical results of our patients treated in this way.
  
  
  METHODS
  From March 1999 to March 2003, a total of 96 patients aged 28 to 86 years (mean 61 years) with clinical stage T(1)/T(2)N(0)M(0), pathologically confirmed renal-cell carcinoma underwent HALRN. The outcomes were compared with those of open radical nephrectomy, which was performed in 86 patients from November 1991 to February 1999 in our institution. Kaplan-Meier analysis was used to analyze survival.
  
  
  RESULTS
  Ten patients (10.4%) had perioperative complications. During a mean follow-up of 25 months (range 6-54 months), no patients died of the cancer, although three patients had metastatic disease. The 4-year disease- free and overall survival rates were 88% and 100%, respectively. Seventy-eight patients who underwent open radical nephrectomy were followed for 38 to 156 months (median 86 months). Seventy-three survived without any recurrent disease, five survived with metastasis, and no patient died of metastatic disease. The 4-year disease-free and overall survival rates were 93% and 100%, respectively.
  
  
  CONCLUSIONS
  Hand-assisted laparoscopic surgical management of T(1)/T(2) renal-cell carcinoma is feasible and safe. At our institution, HALRN confers long-term oncologic effectiveness equivalent to that of open radical nephrectomy.
authors.affiliation: Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Harano
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Eto
authors.forename: Kazuya
authors.initials: K
authors.lastname: Omoto
authors.forename: Katsunori
authors.initials: K
authors.lastname: Tatsugami
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nomura
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Koga
authors.forename: Morifumi
authors.initials: M
authors.lastname: Hojyo
authors.forename: Akito
authors.initials: A
authors.lastname: Yamaguchi
authors.forename: Seiji
authors.initials: S
authors.lastname: Naito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications; D015996:Survival Rate