title: Laparoscopic versus open partial nephrectomy for clinical T1 renal masses: no impact of surgical approach on perioperative complications and long-term postoperative quality of life.
abstract: OBJECTIVE
  Beyond oncological safety, consideration of 30-day complications according to Clavien-Dindo, as well as postoperative quality of life (QoL) after nephron-sparing surgery for clinical T1 renal masses, represents important factors for treatment decision counseling. The objective of this study was to compare the effect of laparoscopic versus open partial nephrectomy (LPN vs. OPN) on 30-day complications and long-term postoperative QoL for clinical T1 renal masses.
  
  
  METHODS
  Retrospective, longitudinal analysis of 293 patients treated with either LPN versus OPN for T1 renal masses. The investigated endpoints were 30-day Clavien-Dindo complications and health-related QoL (EORTC QLQ-C30). Respectively, logistic and linear regression models analyzed the effect of surgical partial nephrectomy approach on endpoints.
  
  
  RESULTS
  Overall complication rates were similar in patients undergoing OPN or LPN (16.1 vs. 14.6 %, p = 0.8). Significantly less major complications (2.4 vs. 10.4 %, p = 0.025) occurred after LPN. Despite a shorter convalescence period for LPN patients (p = 0.035), in uni- and multivariable analyses, surgical approach was not associated with 30-day complications nor long-term differences in QoL (all p > 0.05).
  
  
  CONCLUSIONS
  Despite a faster recovery time after LPN, our findings suggest that LPN and OPN are equivalent with regard to 30-day Clavien-Dindo complication rates and long-term QoL.
authors.affiliation: Department of Urology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany, a.becker@uke.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Becker
authors.forename: Lea
authors.initials: L
authors.lastname: Pradel
authors.forename: Luis
authors.initials: L
authors.lastname: Kluth
authors.forename: Marianne
authors.initials: M
authors.lastname: Schmid
authors.forename: Christian
authors.initials: C
authors.lastname: Eichelberg
authors.forename: Sascha
authors.initials: S
authors.lastname: Ahyai
authors.forename: Quoc
authors.initials: Q
authors.lastname: Trinh
authors.forename: Daniel
authors.initials: D
authors.lastname: Seiler
authors.forename: Roland
authors.initials: R
authors.lastname: Dahlem
authors.forename: Jens
authors.initials: J
authors.lastname: Hansen
authors.forename: Michael
authors.initials: M
authors.lastname: Rink
authors.forename: Mario
authors.initials: M
authors.lastname: Zacharias
authors.forename: Anja
authors.initials: A
authors.lastname: Mehnert
authors.forename: Corinna
authors.initials: C
authors.lastname: Bergelt
authors.forename: Margit
authors.initials: M
authors.lastname: Fisch
authors.forename: Felix K H
authors.initials: FK
authors.lastname: Chun
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology*; D007668:Kidney / Q000294:innervation / Q000601:surgery; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D059351:Organ Sparing Treatments; D011183:Postoperative Complications / Q000453:epidemiology*; D011788:Quality of Life; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome