The safety and efficacy of laparoscopic microwave ablation-assisted partial nephrectomy: a new avenue for the treatment of cystic renal tumors.

ABSTRACT

PURPOSE: Clinically, the management of cystic renal masses is tricky. The study aims to evaluate the safety and efficacy of laparoscopic microwave ablation-assisted partial nephrectomy (LMAPN) for cystic renal tumors. METHODS AND MATERIALS Between November 2017 and January 2022, LMAPN was performed on 43 patients (29 men and 14 women; age range 22-80 years; median age 54 years) with Bosniak category III (n = 15) or IV (n = 28) cystic renal tumors (size range 1.2-5.0 cm; mean size 2.8 cm). The median follow-up period was 26 months (range 7-56 months). Baseline and perioperative data, pathological features, renal function, postoperative complications and oncologic outcomes were collected and evaluated. RESULTS: Forty-three cystic renal tumors were successfully managed by LMAPN. The mean operating time was 79 min (range 40-130 min). The mean time of renal pedicle clamping was 19 min (range 12-25 min). Mean intraoperative blood loss was 28.4 mL (range 10-80 mL). The mean postoperative hospitalization duration was 4 days (range 2-6 days). Negative surgical margins were diagnosed in all cases. During the follow-up, no patient appeared with distant metastasis, wound or peritoneal cavity implantation. No major but minor complications of Clavien-Dindo grade I were encountered after the operation. The 1-, 3- and 4-year overall survival rate was 100%, 96.6% and 88.5%, respectively. CONCLUSION: This is the first study focusing on LMAPN for cystic renal tumors, demonstrating its favorable feasibility, safety and disease control. Long-term follow-up is necessary to draw conclusions on the preference and advantages of the new therapeutic approach.