Laparoscopic partial nephrectomy: an update on contemporary issues.
Laparoscopic partial nephrectomy (LPN) is a technically challenging procedure with up to 5-year follow-up data. In this article, incidence of renal cell carcinoma, indications, and contraindications for LPN are presented. In addition, LPN for benign diseases such as atrophic renal segments associated with duplicated collecting systems and calyceal diverticula associated with recurrent UTIs are presented. Hilar clamping, ischemic time, positive margins, and port-site metastasis, in addition to complications and survival outcomes, are discussed. The advantages of lower cost, decreased postoperative pain, and early recovery have to be balanced with prolonged warm ischemia. Its long-term outcomes in terms of renal insufficiency or hemodialysis requirements have not been defined completely. Randomized clinical trials comparing open partial nephrectomy (OPN) versus LPN are needed.
Andonian
Sero
S
Smith Institute for Urology, North Shore-Long Island Jewish Health System, 450 Lakeville Road, Suite M-41, New Hyde Park, New York, NY 11040, USA.
Janetschek
Günter
G
Lee
Benjamin R
BR