title: Hand-assisted laparoscopic versus open partial nephrectomy in patients with T1 renal tumor: Comparative perioperative, functional and oncological outcome.
abstract: OBJECTIVE
  Studies comparing hand-assisted laparoscopic partial nephrectomy (HALPN) and open partial nephrectomy (OPN) for T1 kidney tumors are scarce. This study investigated the perioperative, functional and oncological outcomes of these methods.
  
  
  METHODS
  A prospective institutional kidney tumor register was used to identify patients between January 2006 and May 2014 undergoing HALPN (n = 139) or OPN (n = 165) for tumors 7 cm or smaller with non-absolute indication for nephron-sparing surgery. The outcomes were compared using univariate and multivariate statistical methods.
  
  
  RESULTS
  HALPN and OPN groups were similar with regard to tumor characteristics but HALPN patients were 2 years younger (p = 0.001) and had less comorbidity. Fewer intraoperative complications were encountered in HALPN than in OPN patients (7.2% vs 12.7%, p = 0.043). HALPN patients had less all-grade postoperative 30 day complications than OPN patients (27% vs 41%, p = 0.037), but there was no significant difference in Clavien 3-5 complications. Glomerular filtration rate 3 months after operation was lower in the HALPN than in the OPN group (7.1 ± 12.7% vs 10.0 ± 12.4%, p = 0.054). There was no difference in overall survival or recurrence-free survival during the median follow-up of 35 months.
  
  
  CONCLUSIONS
  HALPN is a feasible method to achieve equal perioperative, functional and oncological outcomes compared to OPN in patients with tumors 7 cm or smaller in diameter.
authors: a 1 Department of Urology, Helsinki University Hospital , Helsinki, Finland.
authors: Harry
authors: H
authors: Nisen
authors: a 1 Department of Urology, Helsinki University Hospital , Helsinki, Finland.
authors: Petrus
authors: P
authors: Järvinen
authors: a 1 Department of Urology, Helsinki University Hospital , Helsinki, Finland.
authors: Tuomas
authors: T
authors: Kilpeläinen
authors: a 1 Department of Urology, Helsinki University Hospital , Helsinki, Finland.
authors: Riikka
authors: R
authors: Järvinen
authors: a 1 Department of Urology, Helsinki University Hospital , Helsinki, Finland.|b 2 Department of Oncology, Helsinki University Hospital Cancer Center , Helsinki, Finland.
authors: Harri
authors: H
authors: Visapää
authors: a 1 Department of Urology, Helsinki University Hospital , Helsinki, Finland.
authors: Kimmo
authors: K
authors: Taari
keywords: Hand-assisted partial nephrectomy; kidney cancer; kidney function; partial nephrectomy; perioperative complications