Minimally invasive partial nephrectomy for single versus multiple renal tumors.
J Urol
; 189(2): 462-7, 2013 Feb.
Article
em En
| MEDLINE
| ID: mdl-23253959
ABSTRACT
PURPOSE:
We report the perioperative outcomes of robotic/laparoscopic partial nephrectomy for multiple tumors at a single operative session. Outcomes were compared with those of a matched pair cohort treated with partial nephrectomy for a single renal tumor. MATERIALS ANDMETHODS:
We retrospectively reviewed a prospectively maintained database from 2001 to 2010 and identified 33 patients who underwent partial nephrectomy for multiple tumors. They were matched 1 to 1 with 33 patients treated with partial nephrectomy for a single tumor. The multiple and single groups were matched for dominant tumor size (3.2 and 3.3 cm, p = 0.61), patient age (60 and 57 years, p = 0.59) and baseline estimated glomerular filtration rate (79.7 and 91.8 ml per minute/1.73 m(2), p = 0.11), respectively.RESULTS:
A total 114 tumors were excised, including 81 in the multiple cohort. There was a median of 2 tumors per kidney (range 2 to 6). In the multiple and single tumor groups estimated blood loss (250 and 235 ml, p = 0.46) and warm ischemia time (19 and 30 minutes, respectively, p = 0.18) were similar. Median operative time (300 vs 217 minutes, p = 0.002) and hospital stay (3 vs 1 days, p = 0.005) were longer in the multiple group. There were 2 conversions to laparoscopic radical nephrectomy per group. Overall, complications developed in 11 (33%) vs 7 patients (21%) treated with partial nephrectomy for multiple vs single tumors (p = 0.40). Median estimated glomerular filtration rate at discharge home was 62.8 vs 67.6 ml per minute/1.73 m(2) in the multiple vs single tumor groups (p = 0.53). Histology confirmed malignancy in 82% and 67% of patients, respectively (p = 0.26). One recurrent tumor in the multiple group had a focal positive margin.CONCLUSIONS:
Robotic/laparoscopic partial nephrectomy can be safely performed for multiple ipsilateral tumors with perioperative outcomes similar to those in patients with a solitary tumor.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Robótica
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Laparoscopia
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Neoplasias Renais
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Nefrectomia
Tipo de estudo:
Observational_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article