title: Comparison of two different renorrhaphy techniques in retroperitoneal laparoscopic partial nephrectomy for complex tumor.
abstract: BACKGROUND
  Partial nephrectomy is currently the standard treatment for clinical T1 renal neoplasms, as it can provide oncologic outcomes equivalent to radical nephrectomy. The aim was to evaluate the efficacy of self-retaining suture (SRS) in renorrhaphy technique in retroperitoneal laparoscopic partial nephrectomy (LPN) for a single renal mass of moderate or high complexity by assessing peri-operative outcomes.
  
  
  METHODS
  A retrospective analysis was done of 64 patients between 2010 and 2012 for complex renal mass (RENAL score ≥ 7) in whom retroperitoneal LPN was performed with two layers using continuous knotless barbed suture (Quill PDO SRS group; n = 34) and absorbable vicryl (non-SRS group; n = 30), respectively. Cases were matched for RENAL score. All the surgical procedures were performed by the same surgeon with experience of more than 500 cases of LPN. Comparisons were made in patients and preoperative outcomes and peri-operative complications between SRS group and non-SRS group.
  
  
  RESULTS
  Mean warm ischemia time (WIT) in SRS group was less than non-SRS group (18.0 vs. 24.8 minutes, P = 0.021). Renorrhaphy suture cost in SRS group was lower than non-SRS group ($269.6 vs. $335.8, P = 0.001). There were no significant differences between the two groups for postoperative changes in creatinine and estimated glomerular filtration rate and the rate of peri-operative complications.
  
  
  CONCLUSIONS
  SRS was safe for complex renal tumor with two layers, continuous and unknot suture, during LPN and would reduce the WIT and renorrhaphy suture cost significantly.
authors.affiliation: Department of Urology, Chinese People's Liberation Army General Hospital, Beijing 100853, China; Department of Urology, Taiyuan City Center Hospital, Taiyuan, Shanxi 030009, China.
authors.forename: Ji-Wen
authors.initials: JW
authors.lastname: Shang
authors.affiliation: Department of Urology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Urology, Chinese People's Liberation Army General Hospital, Beijing 100853, China. Email: xzhang301@126.com.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Urology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Hong-Zhao
authors.initials: HZ
authors.lastname: Li
authors.affiliation: Department of Urology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Tao-Ping
authors.initials: TP
authors.lastname: Shi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012189:Retrospective Studies; D013536:Suture Techniques; D052096:Warm Ischemia