title: Selection of personalized laparoscopic partial nephrectomy based on tumor characteristics: A preliminary study in a single center.
abstract: OBJECTIVE
  To evaluate the feasibility and therapeutic outcome of a personalized laparoscopic partial nephrectomy (LPN) selection scheme designed according to tumor characteristics.
  
  
  METHODS
  We included 187 patients in this study with clinical T1 renal tumors who were diagnosed between March 2012 and February 2014. 93 patients underwent the personalized LPN on the basis of tumor characteristics (Group A, n = 93), including no renal arterial clamping LPN, selective renal arterial clamping LPN and main renal arterial clamping LPN, and the other 94 patients underwent LPN with main renal arterial clamping (Group B, n = 94). Patient characteristics, tumor characteristics, perioperative data and renal function parameters were collected prospectively.
  
  
  RESULTS
  85 patients in Group A and 90 patients in Group B completed the designed surgery without conversion. Compared with Group B, the operation time was longer in Group A (110.2 vs. 122.3 min, p = 0.001), intraoperative blood loss was increased (127.8 vs. 151.1 ml, p = 0.017), and there was less reduction in GFR 12 months postoperative (7.6 vs. 5.1 ml/min, p < 0.001). The study was limited by the relatively small sample size and long-term postoperative renal function is still awaited.
  
  
  CONCLUSIONS
  The result of our study showed that, although the intraoperative blood loss was greater, there was a less decrease in GFR 12 months postoperative in personalized LPN group.
authors.affiliation: Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China; Department of Pathology, New York University Langone Medical Center, New York, USA.
authors.forename: Lu
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Xiuwu
authors.initials: X
authors.lastname: Pan
authors.affiliation: Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Xingang
authors.initials: X
authors.lastname: Cui
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, USA.
authors.forename: Qiufeng
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yin
authors.affiliation: Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Linhui
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China. Electronic address: destiny_cl@hotmail.com.
authors.forename: Danfeng
authors.initials: D
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D003250:Constriction; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D011184:Postoperative Period; D057285:Precision Medicine; D012077:Renal Artery; D016896:Treatment Outcome; D055815:Young Adult
keywords: Ischemia injury; Laparoscopy; Partial nephrectomy