The Early Experience of Laparoscopic Radical Nephrectomy: Laparoscopic versus Open Radical Nephrectomy

Lee, Seung Wook; Lee, Jong Jin; Lee, Tchun Yong

Abstract

PURPOSE: The laparoscopic technique of a radical or total nephrectomy for renal masses and a radical nephroureterectomy for transitional cell carcinomas has recently gained rapid momentum as an effective method of extirpative surgery. We evaluated our experience of laparoscopic radical nephrectomy (LRN) and compared the results to those of contemporary series of open radical nephrectomy (ORN) in renal cell carcinomas.
MATERIALS AND METHODS
Eight males and 5 females underwent a LRN for suspicious renal cell carcinomas. The operations were performed via a transperitoneal route. We retrospectively evaluated the efficacy of the LRN compared to a contemporary group of 13 patients who underwent an ORN for renal cell carcinomas.
RESULTS
For the same period, the results of the LRN (13 patients) and the ORN (13 patients) were compared, and no significant differences were found in: body mass index (24.7 versus 22.8kg/m2, p=0.08), specimen weight (377 versus 431gm, p>0.1) or mass size (3.7 versus 4.4cm, p>0.1). The LRN group had significantly reduced estimated blood losses (433 versus 866ml, p=0.01), pain medication requirements (145 versus 225mg, p=0.04) and times to ambulate (19 versus 32 hours, p=0.02). The operating time, however, was much longer in the LRN compared to the ORN (284 versus 193 min., p=0.09) group.
CONCLUSIONS
Although a LRN has a longer operation time, it has similar efficacy, and is more tolerated by patients than an ORN. Thus, LRN may be a viable alternative for managing localized renal tumors.