Complications of laparoscopic partial nephrectomy.
OBJECTIVE
To review the current evidence about laparoscopic partial nephrectomy (LPN) and its complications to define the role of this technique and to demonstrate specific operative modifications developed in a high volume laparoscopy centre.


METHODS
The most recent literature was reviewed based on a PubMed search to evaluate the current types and rates of surgical complications following laparoscopic partial nephrectomy. Own data and experiences were added. Particular alert was dedicated to detailed operative knowledge to avoid typical pitfalls.


RESULTS
LPN is still a challenging option for treatment of small renal cell cancer (RCC) and the technique is under development. The intermediate-term functional and oncological results of LPN can compete with the standard options at least in laparoscopy dedicated centres. The learning curve has to be considered because of its great impact on the reduction of the risk of complications. Advantages of LPN are less blood loss, shorter hospital stay and less blood loss. A careful case selection is required in reliance on the surgeons; experience.


CONCLUSIONS
LPN is an additional but still challenging option for selected cases of RCC, which should be managed by the hands of experienced surgeons. Respecting these restrictions LPN has been shown to be equivalent to open partial nephrectomy. Distinctive attention has to be dedicated for improvement and standardization of operative techniques to decrease the learning curve of future users.
Zimmermann
Reinhold
R
Department of Urology, Elisabethinen Hospital, University affiliated Hospital, Linz, Austria. reinhold.zimmermann@elisabethinen.or.at
Janetschek
Günter
G
D002292:Carcinoma, Renal Cell / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects*; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications