Selection of personalized laparoscopic partial nephrectomy based on tumor characteristics: A preliminary study in a single center.

ABSTRACT

OBJECTIVES: To evaluate the feasibility and therapeutic outcome of a personalized laparoscopic partial nephrectomy (LPN) selection scheme designed according to tumor characteristics. METHODS: We included 187 patients in this study with clinical T1 renal tumors who were diagnosed between March 2012 and February 2014. 93 patients underwent the personalized LPN on the basis of tumor characteristics (Group A, n = 93), including no renal arterial clamping LPN, selective renal arterial clamping LPN and main renal arterial clamping LPN, and the other 94 patients underwent LPN with main renal arterial clamping (Group B, n = 94). Patient characteristics, tumor characteristics, perioperative data and renal function parameters were collected prospectively. RESULTS: 85 patients in Group A and 90 patients in Group B completed the designed surgery without conversion. Compared with Group B, the operation time was longer in Group A (110.2 vs. 122.3 min, p = 0.001), intraoperative blood loss was increased (127.8 vs. 151.1 ml, p = 0.017), and there was less reduction in GFR 12 months postoperative (7.6 vs. 5.1 ml/min, p < 0.001). The study was limited by the relatively small sample size and long-term postoperative renal function is still awaited. CONCLUSIONS: The result of our study showed that, although the intraoperative blood loss was greater, there was a less decrease in GFR 12 months postoperative in personalized LPN group.