Laparoscopic resection of isolated fossa recurrence of renal cell carcinoma after open nephrectomy: report of 6 cases and literature review.
OBJECTIVE
Local recurrence after a correct surgical technique and absence of distant metastasis is a rare occurrence after radical nephrectomy. Surgical resection remains the standard management for this pathological setting. Nevertheless controversy persists over surgical approach and adjuvant treatments.


METHODS
We report on perioperative outcomes of a small multi-institutional series of patients with fully laparoscopic management of isolated renal fossa recurrence following open radical nephrectomy.


RESULTS
All patients underwent full laparoscopic surgery. Mean operative time was 140 minutes (range 75 to 240 minutes). Only one patient had a Clavien Grade IIIa complication. Mean hospital stay was 3 days (range 2 to 4 days). Out of the six patients, 5 had a mean follow-up of 20 months (range 9 to 32 months). Only one of these patients evolved with distant metastasis after surgery.


CONCLUSIONS
Laparoscopic resection of local recurrence after open radical nephrectomy is a challenging but reproducible technique. There is still no consensus or an operative protocol for this clinical setting. However, as long as surgery is kept within the possibilities, a laparoscopic approach should be sought.
Departamento de Urologia. Hospital Aleman. Buenos Aires. Argentina.
Gonzalo
G
Vitagliano
Departamento de Urologia. Hospital Aleman. Buenos Aires. Argentina.
Carlos
C
Ameri
Clinica Indisa. Universidad Andres Bello. Santiago de Chile. Chile.
Octavio
O
Castillo
Departamento de Urologia. Hospital Britanico. Buenos Aires. Argentina.
Jose
J
Rozanec
D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery; D003964:Diaphragm / Q000293:injuries; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009392:Nephrectomy; D012186:Retroperitoneal Neoplasms / Q000556:secondary* / Q000601:surgery; D016896:Treatment Outcome