Yıl: 2020 Cilt: 19 Sayı: 3 Sayfa Aralığı: 130 - 135 Metin Dili: İngilizce DOI: 10.4274/uob.galenos.2020.1772 İndeks Tarihi: 19-10-2020

Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients

Öz:
Objective: The best therapeutic option for renal tumours smaller than 7 cm is partial nephrectomy. The aim of this study was to compare the positive surgical margin (PSM) rates, recurrence rates and oncological outcomes between laparoscopic partial nephrectomies and open partial nephrectomies at a single tertiary referral centre.Materials and Methods: We included patients with renal tumours treated with partial nephrectomies between January 2008 and December 2016 in the study. We retrospectively reviewed the patients’ demographic data, surgical reports, clinical charts, laboratory results and histopathological reports. Binary regression analysis was used to assess the impact of the tumour diameter, laterality, polarity and localization for PSM.Results: We included a total of 215 patients in the study. The mean preoperative and postoperative haemoglobin and creatinine levels, blood loss, time of surgery and follow-up periods was similar between the two groups. The mean ischaemic time in the open partial nephrectomy group was significantly lower than that of the laparoscopic partial nephrectomy group (p<0.05). Local recurrence was seen in a patient with a PSM in the laparoscopic partial nephrectomy group. However, recurrences were also seen in the negative surgical margin patients in both the open partial nephrectomy and laparoscopic partial nephrectomy groups.Conclusion: The presence of a PSM is not associated with an increased risk of distant metastases or local recurrences. However, higher PSM rates were associated with the early learning curve for a laparoscopic procedure. Finally, an open partial nephrectomy is associated with shorter warm ischaemia time compared to laparoscopic partial nephrectomy group.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Ljungberg B, Bensalah K, Canfield S, et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol 2015;67:913-924.
  • Campbell SC, Novick AC, Belldegrun A, et al. Guideline for management of clinical T1 renal mass. J Urol 2009;182:1271-1279.
  • Ghavamian R, Cheville JC, Lohse CM, et al. Renal cell carcinoma in the solitary kidney: an analysis of complications and outcome after nephron sparing surgery. J Urol 2002;168:454-459.
  • Gill IS, Aron M, Gervais DA, Jewett MA. Clinical practice. Small renal mass. N Engl J Med 2010;362:624-634.
  • Laganosky DD, Filson CP, Master VA. Surgical margins in nephronsparing surgery for renal cell carcinoma. Curr Urol Rep 2017;19:8.
  • Power NE, Silberstein JL, Touijer K. Is laparoscopic partial nephrectomy already the gold standart for small renal masses? Arch Esp Urol 2013;66:90-98.
  • Hermanek P, Wittekind C. The pathologist and the residual tumor (R) classification. Pathol Res Pract 1994;190:115-123.
  • Khalifeh A, Autorino R, Hillyer SP, et al. Comparative outcomes and assessment of Trifecta in 500 robotic and laparoscopic partialnephrectomy cases: a single surgeon experience. J Urol 189:1236-1242. Hung AJ, Cai J, Simmons MN, Gill IS. ‘‘Trifecta’’ in partial nephrectomy. J Urol 2013;189:36-42.
  • Fuhrman SA, Lasky LC, Limas C. Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol 1982;6:655-663.
  • Moch H, Cubilla AL, Humphrey PA, et al. The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours. Eur Urol 2016;70:93-105.
  • Kwon EO, Carver BS, Snyder ME, Russo P. Impact of positive surgical margins in patients undergoing partial nephrectomy for renal cortical tumours. BJU Int 2007;99:286-289.
  • Petros FG, Metcalfe MJ, Yu KJ, et al. Oncologic outcomes of patients with positive surgical margin after partial nephrectomy: a 25-year single institution experience. World J Urol 2018;36:1093-1101.
  • Kang HW, Lee SK, Kim WT, et al. Surgical margin does not influence recurrence rate in pT1 clear cell renal cell carcinoma after partial nephrectomy: A multicenter study. J Surg Oncol 2016;114:70-74.
  • Vincenzoa F, Alessandro C, Inferrera A, et al. Positive Surgical Margins After Partial Nephrectomy: A Systematic Review and Meta-Analysis of Comparative Studies. Kidney Cancer 2018;2:133-145.
  • Salami SS, George AK, Rais-Bahrami S, et al. Off-clamp laparoscopic partial nephrectomy for hilar tumors: oncologic and renal functional outcomes. J Endourol 2014;28:191-195.
  • Tabayoyong W, Abouassaly R, Kiechle JE, et al. Variation in Surgical Margin Status by Surgical Approach among Patients Undergoing Partial Nephrectomy for Small Renal Masses. J Urol 2015;194:1548-1553.
  • Gozen AS, Gherman V, Akin Y, et al. Evaluation of the complications in laparoscopic retroperitoneal radical nephrectomy; An experience of high volume centre. Arch Ital Urol Androl 2017;31;89:266-271.
  • Chang KD, Abdel Raheem A, Kim KH, et al. Functional and oncological outcomes of open, laparoscopic and robot-assisted partial nephrectomy: a multicentre comparative matched-pair analyses with a median of 5 years’ follow-up. BJU Int 2018;122:618-626.
  • 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 167:61-64.
  • Russo P. Renal cell carcinoma: presentation, staging, and surgical treatment. Semin oncol 2000;27:160-176.
  • Sun M, Shariat SF, Cheng C, et al. Prognostic factors and predictive models in renal cell carcinoma: a contemporary review. Eur Urol 2011;60:644-661.
  • Springer C, Hoda MR, Fajkovic H, et al. Laparoscopic vs open partial nephrectomy for T1 renal tumours: evaluation of longterm oncological and functional outcomes in 340 patients. BJU Int 2013;111:281-288.
  • Minervini A, Siena G, Antonelli A, et al. Open versus laparoscopic partial nephrectomy for clinical T1a renal masses: a matched-pair comparison of 280 patients with TRIFECTA outcomes (RECORd Project.). World J Urol 2014;32:257-263.
APA çinar ö, Bolat M, Cicek M, Ozmerdiven G, Aytac Vuruskan B, Vuruskan H (2020). Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients. , 130 - 135. 10.4274/uob.galenos.2020.1772
Chicago çinar önder,Bolat Mustafa Suat,Cicek Mehmet Cagatay,Ozmerdiven Gokhun,Aytac Vuruskan Berna,Vuruskan Hakan Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients. (2020): 130 - 135. 10.4274/uob.galenos.2020.1772
MLA çinar önder,Bolat Mustafa Suat,Cicek Mehmet Cagatay,Ozmerdiven Gokhun,Aytac Vuruskan Berna,Vuruskan Hakan Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients. , 2020, ss.130 - 135. 10.4274/uob.galenos.2020.1772
AMA çinar ö,Bolat M,Cicek M,Ozmerdiven G,Aytac Vuruskan B,Vuruskan H Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients. . 2020; 130 - 135. 10.4274/uob.galenos.2020.1772
Vancouver çinar ö,Bolat M,Cicek M,Ozmerdiven G,Aytac Vuruskan B,Vuruskan H Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients. . 2020; 130 - 135. 10.4274/uob.galenos.2020.1772
IEEE çinar ö,Bolat M,Cicek M,Ozmerdiven G,Aytac Vuruskan B,Vuruskan H "Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients." , ss.130 - 135, 2020. 10.4274/uob.galenos.2020.1772
ISNAD çinar, önder vd. "Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients". (2020), 130-135. https://doi.org/10.4274/uob.galenos.2020.1772
APA çinar ö, Bolat M, Cicek M, Ozmerdiven G, Aytac Vuruskan B, Vuruskan H (2020). Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients. Üroonkoloji Bülteni, 19(3), 130 - 135. 10.4274/uob.galenos.2020.1772
Chicago çinar önder,Bolat Mustafa Suat,Cicek Mehmet Cagatay,Ozmerdiven Gokhun,Aytac Vuruskan Berna,Vuruskan Hakan Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients. Üroonkoloji Bülteni 19, no.3 (2020): 130 - 135. 10.4274/uob.galenos.2020.1772
MLA çinar önder,Bolat Mustafa Suat,Cicek Mehmet Cagatay,Ozmerdiven Gokhun,Aytac Vuruskan Berna,Vuruskan Hakan Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients. Üroonkoloji Bülteni, vol.19, no.3, 2020, ss.130 - 135. 10.4274/uob.galenos.2020.1772
AMA çinar ö,Bolat M,Cicek M,Ozmerdiven G,Aytac Vuruskan B,Vuruskan H Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients. Üroonkoloji Bülteni. 2020; 19(3): 130 - 135. 10.4274/uob.galenos.2020.1772
Vancouver çinar ö,Bolat M,Cicek M,Ozmerdiven G,Aytac Vuruskan B,Vuruskan H Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients. Üroonkoloji Bülteni. 2020; 19(3): 130 - 135. 10.4274/uob.galenos.2020.1772
IEEE çinar ö,Bolat M,Cicek M,Ozmerdiven G,Aytac Vuruskan B,Vuruskan H "Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients." Üroonkoloji Bülteni, 19, ss.130 - 135, 2020. 10.4274/uob.galenos.2020.1772
ISNAD çinar, önder vd. "Experiences of Laparoscopic Partial Nephrectomy for T1a Kidney Tumours: Results of Two Hundred and Fifteen Patients". Üroonkoloji Bülteni 19/3 (2020), 130-135. https://doi.org/10.4274/uob.galenos.2020.1772