Department of Urology, Labbafinejad Hospital, Urology and Nephrology Research Centre, 9th Bousan St., Pasdaran Ave., P.O. Box 16666-94516, Tehran, Iran.
Int Urol Nephrol. 2011 Jun;43(2):371-6. doi: 10.1007/s11255-010-9812-x. Epub 2010 Aug 1.
The use of laparoscopic partial nephrectomy (LPN) in patients with tumours >4 cm remains to be further evaluated. We report our experience with LPN in tumours >4 cm compared with tumours ≤4 cm.
This is a retrospective study of data from all LPN patients operated from 2003 to 2008. Inclusion criteria were a single organ confined contrast enhancing mass/Bosniac III-IV cyst. Hospital admission records were used to extract operative and follow-up data. Patients were grouped into group A: ≤4 cm (32 patients, 53% of total), and group B: >4 cm (28 patients, 47% of total).
A total of 60 patients (mean ± SD age, 47.4 ± 13.4 years; M/F, 36/24) were included. Mean ± SD tumour size was 31.5 ± 7.3 mm and 51.6 ± 10.9 mm in groups A and B, respectively. (P < 0.001) Malignant pathology was present in 22 (69%) and 16 patients (57%) in groups A and B, respectively. (P > 0.05) There was no statistically significant difference in age, gender, pre-operative creatinine, estimated glomerular filtration rate (eGFR), and other investigated pre-operative characteristics between study groups. (all P > 0.05) Nor any difference was observed regarding operative and pathologic (warm ischaemia time, operation duration, transfusion, positive margins, and malignant histology) as well as post-operative variables (re-hospitalization, post-operative complications, hospital stay, or eGFR changes).
The results of this study supports the feasibility and comparability of operative and post-operative early complications for LPN when applied to tumours >4 cm in selected patients compared with tumours ≤4 cm.
在肿瘤＞4cm 的患者中，腹腔镜部分肾切除术（LPN）的应用仍需进一步评估。我们报告了与肿瘤≤4cm 相比，LPN 治疗＞4cm 肿瘤的经验。
这是一项回顾性研究，纳入了 2003 年至 2008 年期间所有接受 LPN 治疗的患者的数据。纳入标准为单个器官局限性强化肿块/ Bosniac III-IV 囊肿。从住院记录中提取手术和随访数据。患者被分为 A 组：≤4cm（32 例，占总数的 53%）和 B 组：＞4cm（28 例，占总数的 47%）。
共纳入 60 例患者（平均年龄±标准差，47.4±13.4 岁；男/女，36/24）。A 组和 B 组的肿瘤平均大小分别为 31.5±7.3mm 和 51.6±10.9mm（P＜0.001）。A 组和 B 组中分别有 22 例（69%）和 16 例（57%）患者存在恶性病理。（P＞0.05）两组间年龄、性别、术前肌酐、估算肾小球滤过率（eGFR）和其他术前特征无统计学差异（均 P＞0.05）。手术和病理（热缺血时间、手术时间、输血、阳性切缘和恶性组织学）以及术后变量（再次住院、术后并发症、住院时间或 eGFR 变化）也无差异。
本研究结果支持在选择的患者中，与肿瘤≤4cm 相比，LPN 应用于＞4cm 肿瘤在手术和术后早期并发症方面的可行性和可比性。
