Comparison of radical nephrectomy techniques in one center: minimal incision portless endoscopic surgery versus laparoscopic surgery.
This study was designed to assess the intraoperative and postoperative benefits of two techniques for treating renal cell carcinoma (portless endoscopic surgery with radical nephrectomy [PLES-RN] and laparoscopic radical nephrectomy [LRN]) carried out at a single center. Radical nephrectomy with either PLES-RN (14 cases) or LRN (15 cases) was carried out on 29 patients with cT1 renal cell carcinoma. There were no statistically significant between-group differences in patient characteristics (except tumor side), operation time, and amount of blood loss (chi(2) and Fisher's test). No blood transfusions were required in either group. The mean incision length of PLES-RN was not significantly longer than that of LRN. No minor or major complications resulted. From postoperative data, the first intake of fluid (P = 0.07) and food (P = 0.02) tended to be sooner in the PLES group than the LRN group. Postsurgically, white blood cell count and C-reactive protein were not significantly different between the two groups. The added cost of disposable instruments needed in LRN was 111 570 Japanese yen (1115.7 United States dollars). Both techniques are optimal options for surgically treating early renal cell carcinoma. The comparison related to invasiveness between the two methods should be evaluated using a large number of cases focusing on the various aspects for the future.
Soga
Norihito
N
Division of Nephro-Urologic Surgery and Andrology, Department of Reparative and Regenerative Medicine, Institute of Medical Life Science, Mie University Graduate School of Medicine, Tsu, Mie, Japan. n-soga@clin.medic.mie-u.ac.jp
Kato
Manabu
M
Masui
Satoru
S
Nishikawa
Kouhei
K
Hasegawa
Yoshihiro
Y
Yamada
Yasushi
Y
Kise
Hideaki
H
Arima
Kiminobu
K
Sugimura
Yoshiki
Y
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D055815:Young Adult