title: Integration of laparoscopic partial nephrectomy into an Australian public hospital: three-year follow-up of our initial 50 cases.
abstract: OBJECTIVE
  To examine the early outcomes and complications of integrating laparoscopic partial nephrectomy (LPN) into a public teaching hospital in Australia.
  
  
  METHODS
  An outcomes review from prospectively collected data on our initial 50 cases of LPN. The median follow-up was 36 months with a minimum follow-up of 2 years and a maximum of 5 years.
  
  
  RESULTS
  The mean patient age was 60 years, mean tumour size was 2.9 cm, and mean baseline creatinine concentration was 79 µmol/L. One patient had a solitary kidney, and one patient had bilateral tumours. The mean operative duration was 168 min, with a mean warm ischaemia time of 25 min. The median blood loss was 100 mL and the median (range) hospital stay was 4 (2-12) days. The complication rate was 6%, including two instances of secondary haemorrhage, and one port-site hernia. No patient required conversion to radical nephrectomy or experienced clinically significant deterioration in their renal function. There have been no local or systemic recurrences to date, with a maximum follow-up of 5 years.
  
  
  CONCLUSIONS
  LPN can be successfully integrated into the Australian public health care sector as standard of care for stage 1 renal masses requiring treatment. Due to the inherent risk of bleeding early in the learning curve, cases should be performed in the setting of adequate surgical and interventional radiographic support.
authors.affiliation: Division of Urology, Austin Health, Heidelberg, Victoria, Australia. gsj1@cornell.edu
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Jack
authors.forename: Mabel
authors.initials: M
authors.lastname: Lua
authors.forename: Yee
authors.initials: Y
authors.lastname: Chan
authors.forename: Damien M
authors.initials: DM
authors.lastname: Bolton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006779:Hospitals, Public; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014739:Victoria