title: Laparoscopic versus Open Partial Nephrectomy: Comparison of Overall and Subgroup Outcomes.
abstract: At experienced centers, laparoscopic partial nephrectomy (LPN) can achieve similar results to those of open surgery (OPN). However, the role of LPN for complex tumors and imperative indications is under debate.
  
  
  
  A total of 356 cases (186 LPN and 170 OPN) between 2005-2012 were reviewed. Clinical, surgical, pathological and radiological data, including PADUA classification were analyzed.
  
  
  
  In overall analysis, OPN was associated with higher tumor complexity (p≤0.03). Subgroup analysis of PADUA >8 tumors (n=85) showed no significant difference between LPN and OPN. In patients with unfavorable treatment characteristics (imperative indication/multifocal tumors, n=71) LPN was beneficial. In this subgroup, LPN led to better perioperative (p≤0.02) and postoperative (p≤0.04) outcome.
  
  
  
  Use of LPN is associated with favorable tumor characteristics. Although no advantage was shown for LPN for tumors with higher complexity (PADUA>8), this large series confirmed the superiority of LPN for imperative indication or multifocal tumors.
authors.affiliation: Department of Urology, Eberhard Karls University, Tuebingen, Germany.|Department of Urology, Assiut University, Assiut, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdelhafez
authors.affiliation: Department of Urology, Eberhard Karls University, Tuebingen, Germany.
authors.forename: Amend
authors.initials: A
authors.lastname: Bastian
authors.affiliation: Department of Urology, Eberhard Karls University, Tuebingen, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Rausch
authors.affiliation: Department of Urology, Eberhard Karls University, Tuebingen, Germany.
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
authors.affiliation: Department of Urology, Eberhard Karls University, Tuebingen, Germany jens.bedke@med.uni-tuebingen.de.
authors.forename: Jens
authors.initials: J
authors.lastname: Bedke
authors.affiliation: Department of Urology, Eberhard Karls University, Tuebingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Kruck
mesh_terms: D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D016896:Treatment Outcome
keywords: Laparoscopy; partial nephrectomy; perioperative outcomes; renal cell carcinoma; renal score