Abstract
Objective: To compare the perioperative and postoperative outcomes of open partial nephrectomy (OPN) and laparoscopic partial nephrectomy (LPN) in clinical T1 renal carcinoma.
Methods: We examined the records of patients who underwent partial nephrectomy at our clinic between January 2016 and May 2020. The records of 20 patients who underwent LPN were compared with the records of 50 patients who underwent OPN. The demographic findings, tumor size, operation time, warm ischemia time (WIT), PADUA nephrometry score, complications, blood loss, preoperative and early postoperative estimated glomerular filtration rate (eGFR), creatinine, and hemoglobin (Hb) values, surgical margins, and hospital stay time of both surgical techniques were compared. Student’s t-test and Mann-Whitney U test were used in the statistical analysis. A p value ≤0.05 was considered significant.
Results: Of the 70 patients, 45 were men and 25 were women, with 42 patients diagnosed with right-sided renal cell carcinoma (RCC) and 28 patients diagnosed with left-sided RCC. The median age was 55 years. Fifty-four patients were diagnosed with clinical T1a RCC, and 16 patients were diagnosed with clinical T1b RCC. The median WIT was shorter in the LPN group. The median tumor size was larger in the OPN group. There was a statistically significant difference between PADUA score and operation time in OPN, while there was no significant difference between OPN and LPN in terms of preoperative and early postoperative eGFR, creatinine, and Hb values. In OPN group, the postoperative creatinine increase was statistically significant compared with preoperative value. This difference was not statistically significant in the LPN group. Clavien-Dindo complications and hospital stay time were higher in OPN.
Conclusion: LPN is an alternative technique to OPN for treatment of clinical T1 RCC when performed by experienced urologists in experienced clinics. It was concluded that postoperative early renal function is better in LPN.