Laparoscopic partial nephrectomy for large renal masses: results of a European survey.
OBJECTIVE
To evaluate the perioperative effectiveness of laparoscopic partial nephrectomy (LPN) for large (4-7 cm) renal masses, with a review of the experience of six European advanced laparoscopic centres.


METHODS
A survey was planned; data were extracted from each institutional data base to obtain information about patients who had undergone LPN for renal masses larger than 4 cm. Demographic, radiological growth patterns of the tumours and intraoperative data were collected. Post-operative complications and pathological data were also recorded. All data were processed through statistical software.


RESULTS
Data on 63 patients were collected. Radiological tumour size was 4.7 cm (4.1-7), growth pattern was cortical in 33 cases and cortico-medullar in 30 cases. Warm ischemia time (WIT) was 25.7 min in 7.3% cases bleeding occurred intra-operatively, post-operative surgical complications occurred in 14.6% cases. Pathological analyses revealed malignant lesion in 73% and positive margins in 6.5%. Complications and positive margins are more frequent for cortico-medullar lesions.


CONCLUSIONS
This survey confirms that LPN for tumours 4-7 cm in size is feasible in experienced hands. WIT and overall complication rate remain questionable points.
Porpiglia
Francesco
F
Division of Urology, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole 10, 10043 Orbassano, Turin, Italy. porpiglia@libero.it
Fiori
Cristian
C
Piechaud
Thierry
T
Gaston
Richard
R
Guazzoni
Giorgio
G
Pansadoro
Vito
V
Bachmann
Alexander
A
Janetschek
Gunter
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005060:Europe / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007511:Ischemia / Q000453:epidemiology / Q000517:prevention & control; D007680:Kidney Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009392:Nephrectomy / Q000379:methods / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies