Our experience with t1 renal masses: Results after 600 laparoscopic partial nephrectomies in Anticancer Research
2017
AOU San Luigi di Orbassano
Tipo pubblicazione
Conference Abstract
Autori/Collaboratori (11)Vedi tutti...
Porpiglia F
Bertolo R
Amparore D
et alii...
Abstract
Introduction: In the last 20 years, partial nephrectomy has become the gold standard treatment in the management of T1 renal tumors. The aim of this study was to evaluate perioperative, pathological and early functional outcomes of patients treated with laparoscopic partial nephrectomy (LPN) for T1 renal tumors. Patients and Methods: All patients who underwent LPN between 06/2000 and 06/2016 were enrolled in this study and analyzed retrospectively. All the surgical procedures were performed by the same surgeon. Demographics variables, such as gender, age, BMI and comorbidity (classified by Charlson Comorbidity Index) were evaluated; preoperative variables, such as side, size and surgical complexity of the lesion (classified by PADUA score), perioperative variables, like blood losses, intra- and postoperative complications (as classified by the Clavien system) and hospital stay were considered. Concerning pathological variables histology and positive surgical margins rate were analyzed. Functional outcomes such as serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) were evaluated preoperatively and at discharge. Results: A total of 600 patients were included in the present study: 410 of them (68.4%) were males, median age was 60 (range=58-63) years, mean BMI was 26.2±6.1 and mean CCI 0.88±0.9. Lesions were rightsided in 52.6% (316/600), with a mean size of 35.4±21.2 mm and a mean PADUA score of 7.9±1.1. Twenty-nine patients (4.8%) had solitary kidney. Concerning perioperative variables mean operative time was 111.4±55.3 min, with mean blood losses of 187.9±230.7 ml. Mean ischemia time was 21.5±15.4 min, 29% (174/600) of the procedures were performed without clamping of the renal artery. Intraoperative complications rate was 1.83% (11/600). The rate of postoperative complications was 8.9% (53/600), with Clavien >3 in 10 patients only. Mean hospital stay was 6±3 days. Concerning pathological findings 125 lesions (20.8%) were benign, wh
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Keywords
adult; bleeding; body mass; cancer size; Charlson Comorbidity Index; clear cell carcinoma; complication; creatinine blood level; estimated glomerular filtration rate; female; gender; histology; hospitalization; human; human tissue; ischemia; kidney artery; kidney cancer; major clinical study; male; middle aged; organ; partial nephrectomy; peroperative complication; postoperative complication; solitary kidney; surgeon; surgery; surgical margin; surgical technique;