Laparoscopic cytoreductive nephrectomy: a three-center retrospective analysis.
BACKGROUND
Metastatic renal cell carcinoma is associated with a poor prognosis. Given the current lack of effective systemic therapies and data suggesting a survival benefit from cytoreductive nephrectomy (CRN) before systemic therapy, we have retrospectively analyzed the experience of laparoscopic cytoreductive nephrectomy (LCRN) in three U.K. centers. The focus of this study was to assess the peri- and postoperative safety and hence feasibility of LCRN in the United Kingdom.


METHODS
Twenty-five patients with metastatic renal cell carcinoma deemed suitable for systemic therapy underwent LCRN in three U.K. centers over a 4-year period.


RESULTS
The tumors ranged from 3.4 cm in diameter to 12 cm. Operating times ranged from 89 (minimum) to 310 minutes (maximum), median 175 minutes. The median amount of blood loss was 150 mL, and hence the transfusion rate was low with only one patient requiring on-table transfusion and two patients requiring additional blood before discharge. Hospital stay ranged between 2.5 and 11 days; median postoperative stay was 3 days.


CONCLUSIONS
In our initial experience, LCRN seems safe and feasible with low morbidity and a good perioperative outcome.
Blick
Christopher
C
Department of Urology, The Churchill Hospital, Oxford, United Kingdom.
Bott
Simon
S
Muneer
Asif
A
Barber
Neil J
NJ
Hindley
Richard
R
Eden
Christopher
C
Sullivan
Mark
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery; D003710:Demography; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D006113:United Kingdom