title: [Comparison of open and laparoscopic partial nephrectomy: a French multicentre experience].
abstract: OBJECTIVE
  To compare open (OPN) and laparoscopic (LPN) partial nephrectomy (PN) techniques in the light of a French multicentre series.
  
  
  METHODS
  Data corresponding to 741 PN (91 laparoscopic and 650 open procedures) were compared in terms of the indications, tumour diameter, operative data, complication rates and length of hospital stay.
  
  
  RESULTS
  Tumours were smaller in the LPN group (2.7 vs 3.4 cm, p = 0.001). There were fewer malignant tumours (71.1% vs 80% p = 0.05) and fewer NP by necessity (20.9% vs 31.4%. p = 0.04) in the LPN group than in the OPN group. There were fewer hilar tumours in the LPN group than in the OPN group (LPN: 4% vs OPN: 14.8%, p = 0.03). Pedicle clamping was performed less frequently in the LPN group (33% vs 50.2%, p = 0.002) but for a significantly longer mean duration (35 minutes vs 19 minutes, p = 0.0001). The mean operating time was longer in the LPN group (163 vs 150 minutes, p = 0.02). The surgical complication rate (17.6% vs 14.3%), transfusion rate (6.6% vs 10.5%) and mean blood loss (363 vs 434 ml) were not significantly different between the 2 groups. There were significantly more urinary fistulas (12.1% vs 2.5%, p < 0.001) and medical complications (24.2% vs 14%, p = 0.01) in the laparoscopy group, but, in the longer-term, urinarvfistula rates were comparable in the 2 groups. The length of hospital stay was shorter for LPN (9.1 vs 11.2 days, p = 0.009).
  
  
  CONCLUSIONS
  This comparative series, reflecting initial experience, shows that laparoscopic partial nephrectomy achieves similar operative and perioperative results to those of open partial nephrectomy. However, the indications for laparoscopic partial nephrectomy remain selective, as the pedicle clamping time and medical complication rates are higher with laparoscopic surgery. Experience and technical progress in laparoscopic partial nephrectomy should make the operative technique comparable to that of open surgery.
authors: Service d'Urologie, Hôpital Pontchaillou, CHU Rennes France. maximecrepel@hotmail.com
authors: Maxime
authors: M
authors: Crepel
authors: Jean-Christophe
authors: JC
authors: Bernhard
authors: Laurent
authors: L
authors: Bellec
authors: Baptiste
authors: B
authors: Albouy
authors: David
authors: D
authors: Lopes
authors: Bertrand
authors: B
authors: Lacroix
authors: Alexandre
authors: A
authors: De la Taille
authors: Laurent
authors: L
authors: Salomon
authors: Christian
authors: C
authors: Pfister
authors: Michel
authors: M
authors: Soulie
authors: Jacques
authors: J
authors: Tostain
authors: Jean-Marie
authors: JM
authors: Ferriere
authors: Claude-C
authors: CC
authors: Abbou
authors: François
authors: F
authors: Guille
authors: Karim
authors: K
authors: Bensalah
authors: Sébastien
authors: S
authors: Vincendeau
authors: Andrea
authors: A
authors: Manunta
authors: Marc
authors: M
authors: Colombel
authors: Jean-Jacques
authors: JJ
authors: Patard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies