Kosin Med J.  2013 Dec;28(2):79-86. 10.7180/kmj.2013.28.2.79.

Current Status of Laparoscopic Partial Nephrectomy

• Kim TS

• KMID: 1993565
• DOI: http://doi.org/10.7180/kmj.2013.28.2.79

Abstract

Recently, nephron-sparing, minimally invasive surgery of small renal masses has become popular. The most typical surgery is laparoscopic partial nephrectomy (LPN). However, due to technical difficulties, the indications for LPN had been limited to small, exophytic, and peripheral tumors. This paper introduces current status of oncological outcomes and technical considerations.

Keyword

Kidney; Laparoscopy; Nephrectomy

MeSH Terms

Kidney
Laparoscopy
Nephrectomy*

Reference

1.Kang SH., Rhew HY., Kim TS. Changes in renal function after laparoscopic partial nephrectomy: comparison with laparoscopic radical nephrectomy. Korean J Urol. 2013. 54:22–5.

2.Zorn KC., Gong EM., Orvieto MA., Gofrit ON., Mikhail AA., Msezane LP, et al. Comparison of laparoscopic radical and partial nephrectomy: effects on long-term serum creatinine. Urology. 2007. 69:1035–40.

3.Weight CJ., Lieser G., Larson BT., Gao T., Lane BR., Campbell SC, et al. Partial nephrectomy is associated with improved overall survival compared to radical nephrectomy in patients with unanticipated benign renal tumours. Eur Urol. 2010. 58:293–8.

4.Thompson RH., Boorjian SA., Lohse CM., Leibovich BC., Kwon ED., Cheville JC, et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol. 2008. 179:468–71.

5.Simmons MN., Weight CJ., Gill IS. Laparoscopic radical versus partial nephrectomy for tumors >4 cm: intermediate-term oncologic and functional outcomes. Urology. 2009. 73:1077–82.

6.Winfield HN., Donovan JF., Godet AS., Clayman RV. Laparoscopic partial nephrectomy: initial case report for benign disease. J Endourol. 1993. 7:521–6.

7.McDougall EM., Clayman RV., Anderson K. Laparoscopic wedge resection of a renal tumor: initial experience. J Laparoendosc Surg. 1993. 3:577–81.

8.Allaf ME., Bhayani SB., Rogers C., Varkarakis I., Link RE., Inagaki T, et al. Laparoscopic partial nephrectomy: evaluation of long-term oncological outcome. J Urol. 2004. 172:871–3.

9.Huang WC., Elkin EB., Levey AS., Jang TL., Russo P. Partial nephrectomy versus radical nephrectomy in patients with small renal tumors--is there a difference in mortality and cardiovascular outcomes? J Urol. 2009. 181:55–61.

10.Crépel M., Jeldres C., Perrotte P., Capitanio U., Isbarn H., Shariat SF, et al. Nephron-sparing surgery is equally effective to radical nephrectomy for T1BN0M0 renal cell carcinoma: a population-based assessment. Urology. 2010. 75:271–5.

11.Kutikov A., Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009. 182:844–53.

12.Ficarra V., Novara G., Secco S., Macchi V., Porzionato A., De Caro R, et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol. 2009. 56:786–93.

13.Simmons MN., Ching CB., Samplaski MK., Park CH., Gill IS. Kidney tumor location measurement using the C index method. J Urol. 2010. 183:1708–13.

14.Canter D., Kutikov A., Manley B., Egleston B., Simhan J., Smaldone M, et al. Utility of the R.E.N.A.L. nephrometry scoring system in objectifying treatment decision-making of the enhancing renal mass. Urology. 2011. 78:1089–94.

15.Rosevear HM., Gellhaus PT., Lightfoot AJ., Kresowik TP., Joudi FN., Tracy CR. Utility of the RENAL nephrometry scoring system in the real world: predicting surgeon operative preference and complication risk. BJU Int. 2012. 109:700–5.

16.Bruner B., Breau RH., Lohse CM., Leibovich BC., Blute ML. Renal nephrometry score is associated with urine leak after partial nephrectomy. BJU Int. 2011. 108:67–72.

17.Mayer WA., Godoy G., Choi JM., Goh AC., Bian SX., Link RE. Higher RENAL Nephrometry Score is predictive of longer warm ischemia time and collecting system entry during laparoscopic and robotic-assisted partial nephrectomy. Urology. 2012. 79:1052–6.

18.Samplaski MK., Hernandez A., Gill IS., Simmons MN. C-index is associated with functional outcomes after laparoscopic partial nephrectomy. J Urol. 2010. 184:2259–63.

19.Deklaj T., Lifshitz DA., Shikanov SA., Katz MH., Zorn KC., Shalhav AL. Laparoscopic radical versus laparoscopic partial nephrectomy for clinical T1bN0M0 renal tumors: comparison of perioperative, pathological, and functional outcomes. J Endourol. 2010. 24:1603–7.

20.Shikanov S., Lifshitz D., Chan AA., Okhunov Z., Ordonez MA., Wheat JC, et al. Impact of ischemia on renal function after laparoscopic partial nephrectomy: a multicenter study. J Urol. 2010. 183:1714–8.

21.Thompson RH., Lane BR., Lohse CM., Leibovich BC., Fergany A., Frank I, et al. Renal function after partial nephrectomy: effect of warm ischemia relative to quantity and quality of preserved kidney. Urology. 2012. 79:356–60.

22.Song C., Bang JK., Park HK., Ahn H. Factors influencing renal function reduction after partial nephrectomy. J Urol. 2009. 181:48–53.

23.Gill IS., Abreu SC., Desai MM., Steinberg AP., Ramani AP., Ng C, et al. Laparoscopic ice slush renal hypothermia for partial nephrectomy: the initial experience. J Urol. 2003. 170:52–6.

24.Landman J., Venkatesh R., Lee D., Vanlangendonck R., Morissey K., Andriole GL, et al. Renal hypothermia achieved by retrograde endoscopic cold saline perfusion: technique and initial clinical application. Urology. 2003. 61:1023–5.

25.Beri A., Lattouf JB., Deambros O., Grüll M., Gschwendtner M., Ziegerhofer J, et al. Partial nephrectomy using renal artery perfusion for cold ischemia: functional and oncologic outcomes. J Endourol. 2008. 22:1285–90.

26.Choi JD., Park JW., Lee SY., Jeong BC., Jeon SS., Lee HM, et al. Does prolonged warm ischemia after partial nephrectomy under pneumoperitoneum cause irreversible damage to the affected kidney? J Urol. 2012. 187:802–6.

27.Funahashi Y., Hattori R., Yamamoto T., Sassa N., Fujita T., Gotoh M. Effect of warm ischemia on renal function during partial nephrectomy: assessment with new 99mTc-mercaptoace-tyltriglycine scintigraphy parameter. Urology. 2012. 79:160–4.

28.Strup S., Garrett J., Gomella L., Rowland R. Laparoscopic partial nephrectomy: hand-assisted technique. J Endourol. 2005. 19:456–9.

29.Pierorazio PM., Patel HD., Feng T., Yohannan J., Hyams ES., Allaf ME. Robotic-assisted versus traditional laparoscopic partial nephrectomy: comparison of outcomes and evaluation of learning curve. Urology. 2011. 78:813–9.

30.Benway BM., Bhayani SB., Rogers CG., Dulabon LM., Patel MN., Lipkin M, et al. Robot assisted partial nephrectomy versus laparoscopic partial nephrectomy for renal tumors: a multi-institutional analysis of perioperative outcomes. J Urol. 2009. 182:866–72.

31.Desai MM., Berger AK., Brandina R., Aron M., Irwin BH., Canes D, et al. Laparoendoscopic single-site surgery: initial hundred patients. Urology. 2009. 74:805–12.

32.Ng CS., Gill IS., Ramani AP., Steinberg AP., Spaliviero M., Abreu SC, et al. Transperitoneal versus retroperitoneal laparoscopic partial nephrectomy: patient selection and perioperative outcomes. J Urol. 2005. 174:846–9.

33.Häcker A., Albadour A., Jauker W., Ziegerhofer J., Albquami N., Jeschke S, et al. Nephron-sparing surgery for renal tumours: acceleration and facilitation of the laparoscopic technique. Eur Urol. 2007. 51:358–65.

34.Shao P., Qin C., Yin C., Meng X., Ju X., Li J, et al. Laparoscopic partial nephrectomy with segmental renal artery clamping: technique and clinical outcomes. Eur Urol. 2011. 59:849–55.

35.Simon J., Bartsch G., Finter F., Hautmann R., de Petriconi R. Laparoscopic partial nephrectomy with selective control of the renal parenchyma: initial experience with a novel laparoscopic clamp. BJU Int. 2009. 103:805–8.

36.Gill IS., Eisenberg MS., Aron M., Berger A., Ukimura O., Patil MB, et al. “Zero ischemia” partial nephrectomy: novel laparoscopic and robotic technique. Eur Urol. 2011. 59:128–34.

37.Rais-Bahrami S., George AK., Herati AS., Srinivasan AK., Richstone L., Kavoussi LR. Off-clamp versus complete hilar control laparoscopic partial nephrectomy: comparison by clinical stage. BJU Int. 2012. 109:1376–81.

38.Wszolek MF., Kenney PA., Lee Y., Libertino JA. Comparison of hilar clamping and non-hilar clamping partial nephrectomy for tumours involving a solitary kidney. BJU Int. 2011. 107:1886–92.

39.Phillips JM., Narula N., Deane LA., Box GN., Lee HJ., Ornstein DK, et al. Histological evaluation of cold versus hot cutting: clinical impact on margin status for laparoscopic partial nephrectomy. J Urol. 2008. 180:2348–52.

40.Timsit MO., Bazin JP., Thiounn N., Fontaine E., Chrétien Y., Dufour B, et al. Prospective study of safety margins in partial nephrectomy: intraoperative assessment and contribution of frozen section analysis. Urology. 2006. 67:923–6.

41.Sutherland SE., Resnick MI., Maclennan GT., Goldman HB. Does the size of the surgical margin in partial nephrectomy for renal cell cancer really matter? J Urol. 2002. 167:61–4.

42.Castilla EA., Liou LS., Abrahams NA., Fergany A., Rybicki LA., Myles J, et al. Prognostic importance of resection margin width after nephron-sparing surgery for renal cell carcinoma. Urology. 2002. 60:993–7.

43.Minervini A., Ficarra V., Rocco F., Antonelli A., Bertini R., Carmignani G, et al. Simple enucleation is equivalent to traditional partial nephrectomy for renal cell carcinoma: results of a nonrandomized, retrospective, comparative study. J Urol. 2011. 185:1604–10.

44.Bensalah K., Pantuck AJ., Rioux-Leclercq N., Thuret R., Montorsi F., Karakiewicz PI, et al. Positive surgical margin appears to have negligible impact on survival of renal cell carcinomas treated by nephron-sparing surgery. Eur Urol. 2010. 57:466–71.

45.Orvieto MA., Chien GW., Laven B., Rapp DE., Sokoloff MH., Shalhav AL. Eliminating knot tying during warm ischemia time for laparoscopic partial nephrectomy. J Urol. 2004. 172:2292–5.

46.Benway BM., Cabello JM., Figenshau RS., Bhayani SB. Sliding-clip renorrhaphy provides superior closing tension during robot-assisted partial nephrectomy. J Endourol. 2010. 24:605–8.

47.Sammon J., Petros F., Sukumar S., Bhandari A., Kaul S., Menon M, et al. Barbed suture for renorrhaphy during robot-assisted partial nephrectomy. J Endourol. 2011. 25:529–33.

48.Bak JB., Singh A., Shekarriz B. Use of gelatin matrix thrombin tissue sealant as an effective hemostatic agent during laparo-scopic partial nephrectomy. J Urol. 2004. 171:780–2.

49.Gill IS., Ramani AP., Spaliviero M., Xu M., Finelli A., Kaouk JH, et al. Improved hemostasis during laparoscopic partial nephrectomy using gelatin matrix thrombin sealant. Urology. 2005. 65:463–6.