March issues of Urology and Physician’s Weekly feature a study providing an analysis of surgical and treatment outcomes laparoscopic partial nephrectomy versus partial nephrectomy for renal cell carcinoma (RCC), the most prevalent form of primary kidney cancer.
About the Study
The team of researchers utilized the institutional RCC database consisting of patients who were treated by way of partial nephrectomy from 1997 through 2018. The urologist who operated in each instance determined the surgical technique to be used based on their practice training. Several timeframes were analyzed. They included perioperative, preoperative, post operative, and recurrence of disease referring to the patient’s time before during and after the hospital.
A total of 1,088 patients underwent a partial nephrectomy within the dates specified above. Two types of partial nephrectomy are open partial nephrectomy (OPN) and laparoscopy (LPN).
About OPN
During OPN the surgeon makes an incision in the abdomen and removes the diseased part of the kidney or if necessary, the entire kidney. The incision is closed in the usual manner.
About LPN
The surgeon uses a wand-like camera (laparoscope) that passes through small incisions (ports) in the abdominal wall. The kidney is removed through an incision using specialized instruments.
Statistical Significance
Study participants and baseline characteristics were not statistically different within the two groups. LPN exhibited somewhat shorter time in surgery (185 versus 205 minutes) and lower blood loss. (150 mL versus 250 mL). LPN had a shorter length of stay (2 versus 4 days) and no substantial difference in high grade complications (2.89 versus 4.32). LPN showed a shorter length of stay (2 versus 4 days) and fewer LPN patients developed metastasis (1.65 versus 4.94). Recurrence rates remained consistent with LPN at 1.24 versus 3.09 for OPN. Renal function was similar in both cohorts. Renal function at the postoperative stage were similar for OPN and LPN.
Long Term Outcomes
The study of both groups suggests that the oncologic results between OPN and LPN have similar tumor and patient characteristics. LPN proved to have advantages in a smaller amount of blood loss and short hospital stays. Its complication rate was also lower. The study showed that renal function was also somewhat similar postoperatively when comparing the two types of surgery.
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Last modified: May 6, 2024
