Laparoscopic partial nephrectomy: 3-year followup.

PURPOSE

LPN is a viable alternative to open partial nephrectomy for select small renal tumors. However, published intermediate term oncological data are sparse. We present our experience with LPN for tumor in 100 patients with a minimum followup of 3 years.

MATERIALS AND METHODS

Of the 480 LPNs performed at our institution a minimum followup of 3 years is available in 100 patients since 1999. Overall and cancer specific survival data were obtained from patient charts, radiographic reports and direct telephone calls to patient families.

RESULTS

All 100 cases were completed laparoscopically without open conversion. Mean tumor size was 3.1 cm and mean warm ischemia was 27 minutes. Final histopathology revealed renal cell carcinoma in 68 patients, including 1 with positive surgical margins. A second patient with oncocytoma had a positive surgical margin. At a median followup of 42 months (mean 42.6, range 24.3 to 62.5) no patient had evidence of local or port site recurrence. Two patients with renal cell carcinoma had a contralateral renal mass. Overall survival was 86% and cancer specific survival was 100%. Mean preoperative and postoperative serum creatinine was 1.1 and 1.3 mg/dl, respectively. Two patients with preoperative chronic renal insufficiency were undergoing hemodialysis.

CONCLUSIONS

At 3-year followup LPN provides oncological outcomes comparable to those in contemporary open partial nephrectomy series.