title: Laparoscopic partial nephrectomy for tumours >4 cm compared with smaller tumours: perioperative results.
abstract: OBJECTIVE
  The use of laparoscopic partial nephrectomy (LPN) in patients with tumours >4 cm remains to be further evaluated. We report our experience with LPN in tumours >4 cm compared with tumours ≤4 cm.
  
  
  METHODS
  This is a retrospective study of data from all LPN patients operated from 2003 to 2008. Inclusion criteria were a single organ confined contrast enhancing mass/Bosniac III-IV cyst. Hospital admission records were used to extract operative and follow-up data. Patients were grouped into group A: ≤4 cm (32 patients, 53% of total), and group B: >4 cm (28 patients, 47% of total).
  
  
  RESULTS
  A total of 60 patients (mean ± SD age, 47.4 ± 13.4 years; M/F, 36/24) were included. Mean ± SD tumour size was 31.5 ± 7.3 mm and 51.6 ± 10.9 mm in groups A and B, respectively. (P < 0.001) Malignant pathology was present in 22 (69%) and 16 patients (57%) in groups A and B, respectively. (P > 0.05) There was no statistically significant difference in age, gender, pre-operative creatinine, estimated glomerular filtration rate (eGFR), and other investigated pre-operative characteristics between study groups. (all P > 0.05) Nor any difference was observed regarding operative and pathologic (warm ischaemia time, operation duration, transfusion, positive margins, and malignant histology) as well as post-operative variables (re-hospitalization, post-operative complications, hospital stay, or eGFR changes).
  
  
  CONCLUSIONS
  The results of this study supports the feasibility and comparability of operative and post-operative early complications for LPN when applied to tumours >4 cm in selected patients compared with tumours ≤4 cm.
authors.affiliation: Department of Urology, Labbafinejad Hospital, Urology and Nephrology Research Centre, 9th Bousan St., Pasdaran Ave., P.O. Box 16666-94516, Tehran, Iran. nouralizadeh@yahoo.com
authors.forename: A
authors.initials: A
authors.lastname: Nouralizadeh
authors.forename: N
authors.initials: N
authors.lastname: Simforoosh
authors.forename: A
authors.initials: A
authors.lastname: Tabibi
authors.forename: A
authors.initials: A
authors.lastname: Basiri
authors.forename: S A M
authors.initials: SA
authors.lastname: Ziaee
authors.forename: M
authors.initials: M
authors.lastname: Soleimani
authors.forename: M H
authors.initials: MH
authors.lastname: Radfar
authors.forename: M
authors.initials: M
authors.lastname: Abedinzadeh
authors.forename: A H
authors.initials: AH
authors.lastname: Kashi
mesh_terms: D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies