title: Comparison of laparoscopic and open partial nephrectomies in t1a renal cell carcinoma: a korean multicenter experience.
abstract: OBJECTIVE
  We analyzed a series of patients who had undergone laparoscopic partial nephrectomies (LPNs) and open partial nephrectomies (OPNs) to compare outcomes of the two procedures in patients with pathologic T1a renal cell carcinomas (RCCs).
  
  
  METHODS
  From January 1998 to May 2009, 417 LPNs and 345 OPNs were performed on patients with small renal tumors in 15 institutions in Korea. Of the patients, 273 and 279 patients, respectively, were confirmed to have pT1a RCC. The cohorts were compared with respect to demographics, peri-operative data, and oncologic and functional outcomes.
  
  
  RESULTS
  The demographic data were similar between the groups. Although the tumor location was more exophytic (51% vs. 44%, p=0.047) and smaller (2.1 cm vs. 2.3 cm, p=0.026) in the LPN cohort, the OPN cohort demonstrated shorter ischemia times (23.4 min vs. 33.3 min, p<0.001). The LPN cohort was associated with less blood loss than the OPN cohort (293 ml vs. 418 ml, p<0.001). Of note, two patients who underwent LPNs had open conversions and nephrectomies were performed because of intra-operative hemorrhage. The decline in the glomerular filtration rate at the last available follow-up (LPN, 10.9%; and OPN, 10.6%) was similar in both groups (p=0.8). Kaplan-Meier estimates of 5-year local recurrence-free survival (RFS) were 96% after LPN and 94% after OPN (p=0.8).
  
  
  CONCLUSIONS
  The LPN group demonstrated similar rates of recurrence-free survival, complications, and postoperative GFR change compared with OPN group. The LPN may be an acceptable surgical option in patients with small RCC in Korea.
authors.affiliation: Department of Urology, School of Medicine, Kangwon National University, Chuncheon, Korea.
authors.forename: Hongzoo
authors.initials: H
authors.lastname: Park
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
authors.forename: Hyeon Hoe
authors.initials: HH
authors.lastname: Kim
authors.forename: Seung Bae
authors.initials: SB
authors.lastname: Lee
authors.forename: Tae Gyun
authors.initials: TG
authors.lastname: Kwon
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Jeon
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Kang
authors.forename: Seong Il
authors.initials: SI
authors.lastname: Seo
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Oh
authors.forename: Youn Soo
authors.initials: YS
authors.lastname: Jeon
authors.forename: Wan
authors.initials: W
authors.lastname: Lee
authors.forename: Tae-Kon
authors.initials: TK
authors.lastname: Hwang
authors.forename: Koon Ho
authors.initials: KH
authors.lastname: Rha
authors.forename: Ill Young
authors.initials: IY
authors.lastname: Seo
authors.forename: Dong Deuk
authors.initials: DD
authors.lastname: Kwon
authors.forename: Yong-June
authors.initials: YJ
authors.lastname: Kim
authors.forename: Yunhee
authors.initials: Y
authors.lastname: Choi
authors.forename: Sue Kyung
authors.initials: SK
authors.lastname: Park