Oncologic outcome of hand-assisted laparoscopic radical nephrectomy.
OBJECTIVE
To evaluate and compare the oncologic outcome of hand-assisted retroperitoneoscopic radical nephrectomy (HALS) with that of open radical nephrectomy.


METHODS
The clinical and follow-up data of 123 patients with localized renal cell carcinoma who underwent HALS were retrospectively compared with those of 70 patients who underwent open radical nephrectomy.


RESULTS
No significant differences were found in operating time, complication rates, or transfusion rates between the HALS and open groups. The estimated blood loss was significantly less in the HALS group. The median follow-up period was 41.0 months for the HALS group, significantly shorter than that for the open group (74.5 months). The 3 and 5-year disease-free survival rate for the HALS and open groups was 94% and 92% and 93% and 91%, respectively. The 3 and 5-year cancer-specific survival rate for the HALS and open groups was 96% and 92% and 98% and 94%, respectively. No significant differences were found in the disease-free and cancer-specific survival rates between the two groups. In the HALS group, no significant differences were found in the disease-free survival rate between those undergoing surgery by less-experienced surgeons who had performed laparoscopic nephrectomy on 10 cases or less and those undergoing surgery by more experienced surgeons.


CONCLUSIONS
The oncologic outcome of HALS did not differ much from that of the open approach. Also, the experience of the surgeon did not affect the oncologic outcome. However, extended follow-up is necessary to assess the true oncologic efficacy of HALS.
Kawauchi
Akihiro
A
Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan. kawauchi@koto.kpu-m.ac.jp
Yoneda
Kimihiko
K
Fujito
Akira
A
Okihara
Koji
K
Soh
Jintetsu
J
Naitoh
Yasuyuki
Y
Mizutani
Yoichi
Y
Miki
Tsuneharu
T
D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies