title: Comparing renal function preservation after laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy for clinical T1a renal tumor: using a 3D parenchyma measurement system.
abstract: OBJECTIVE
  To compare the renal function preservation between laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy.
  
  
  METHODS
  Data were analyzed from 246 patients who underwent laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy for solitary cT1a renal cell carcinoma from January 2013 to July 2015. To reduce the intergroup difference, we used a 1:1 propensity matching analysis. The functional renal parenchyma volume preservation were measured preoperative and 12 months after surgery. The total renal function recovery and spilt GFR was compared. Multivariable logistic analysis was used for predictive factors for renal function decline.
  
  
  RESULTS
  After 1:1 propensity matching, each group including 100 patients. Patients in the laparoscopic radio frequency ablation assisted tumor enucleation had a smaller decrease in estimate glomerular filtration rate at 1 day (-7.88 vs -20.01%, p < 0.001), 3 months (-2.31 vs -10.39%, p < 0.001), 6 months (-2.16 vs -7.99%, p = 0.015), 12 months (-3.26 vs -8.03%, p = 0.012) and latest test (-3.24 vs -8.02%, p = 0.040), also had better functional renal parenchyma volume preservation (89.19 vs 84.27%, p < 0.001), lower decrease of the spilt glomerular filtration rate (-9.41 vs -17.13%, p < 0.001) at 12 months. The functional renal parenchyma volume preservation, warm ischemia time and baseline renal function were the important independent factors in determining long-term functional recovery.
  
  
  CONCLUSIONS
  The laparoscopic radio frequency ablation assisted tumor enucleation technology has unique advantage and potential in preserving renal parenchyma without ischemia damage compared to conventional laparoscopic partial nephrectomy, and had a better outcome, thus we recommend this technique in selected T1a patients.
authors.affiliation: Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China.
authors.forename: Liangsong
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China.
authors.forename: Guangyu
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China.
authors.forename: Jiwei
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China.
authors.forename: Ruiyun
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China.
authors.forename: Wen
authors.initials: W
authors.lastname: Kong
authors.affiliation: Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xue
authors.affiliation: Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China.
authors.forename: Yiran
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China. cyh1488@163.com.
authors.forename: Yonghui
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China. med-zhangjin@vip.sina.com.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods
keywords: Ablation techniques; Functional renal parenchymal; Renal tumor; Three-dimensional volume measurement