title: Is laparoscopic partial nephrectomy already the gold standard for small renal masses?.
abstract: OBJECTIVE
  To examine the role of laparoscopic partial nephrectomy in the management of small renal masses.
  
  
  METHODS
  We searched MEDLINE (through March 2012) using PubMed, the Cochrane Central Search Library (though March 2012), and Web  of Science  (through March 2012). We retrieved citations using the text terms "small renal mass,"  "laparoscopic,"  "partial  nephrectomy,"and "radical  nephrectomy." We limited the search to articles in the English language, to T1a renal tumors, and expanded the search using the related articles  function. We also performed hand searches of references identified in electronically abstracted articles.
  
  
  RESULTS
  There is a paucity of well conducted clinical trials to elucidate laparoscopic partial nephrectomy's role. A number of assumptions had to  be made to complete the review. Other than possibly less operative blood loss, less operative time, less inpatient stay time, and less cost, there  was insufficient evidence to support laparoscopic partial nephrectomy over other modalities. Laparoscopic partial nephrectomy appears to have a higher  rate of radical nephrectomy conversion.
  
  
  CONCLUSIONS
  There is insufficient evidence to clearly state that laparoscopic partial nephrectomy is the gold standard in the management of small  renal masses. If this skill is part of a surgeon's armamentarium, it is certainly not inferior to other modalities, and may offer some benefit to  patients.
authors: Urology Service, Department of Surgery, University of Western Ontario, London, Ontario, Canada.
authors: Nicholas E
authors: NE
authors: Power
authors: Jonathan L
authors: JL
authors: Silberstein
authors: Karim
authors: K
authors: Touijer
mesh_terms: D006801:Humans; D007668:Kidney / Q000502:physiology; D007680:Kidney Neoplasms / Q000191:economics / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D010535:Laparoscopy / Q000191:economics / Q000379:methods* / Q000592:standards; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000379:methods* / Q000592:standards; D009392:Nephrectomy / Q000191:economics / Q000379:methods* / Q000592:standards; D011788:Quality of Life; D016896:Treatment Outcome