Comparison of laparoscopic and open partial nephrectomies in t1a renal cell carcinoma: a korean multicenter experience.
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.
Park
Hongzoo
H
Department of Urology, School of Medicine, Kangwon National University, Chuncheon, Korea.
Byun
Seok-Soo
SS
Kim
Hyeon Hoe
HH
Lee
Seung Bae
SB
Kwon
Tae Gyun
TG
Jeon
Seung Hyun
SH
Kang
Seok Ho
SH
Seo
Seong Il
SI
Oh
Tae Hee
TH
Jeon
Youn Soo
YS
Lee
Wan
W
Hwang
Tae-Kon
TK
Rha
Koon Ho
KH
Seo
Ill Young
IY
Kwon
Dong Deuk
DD
Kim
Yong-June
YJ
Choi
Yunhee
Y
Park
Sue Kyung
SK