Journal List > Korean J Urol > v.47(11) > 1069778

Kim, Kwon, and Kim: Laparoscopic Radical Nephrectomy for T2 Renal Cell Carcinomas

Abstract

Purpose

A laparoscopic radical nephrectomy (LRN) has emerged as the standard care in appropriate candidates with stage T1 renal tumors (7cm or less). We extended our experience of LRN to stage T2 renal tumors (greater than 7cm), and compared the results with those of LRN for stage T1 renal tumors, as well as with those of an open radical nephrectomy (ORN) for stage T2 renal tumors.

Materials and Methods

Between January 2001 and December 2004, a total of 67 patients, who underwent LRN for renal cell carcinomas, were retrospectively subdivided into the LRNT1 (n=48, tumor size≤7cm) or LRNT2 (n=19, tumor size>7cm) groups. The surgical outcomes and perioperative morbidities were retrospectively evaluated. Also, the results of the LRNT2 group were compared with those of the open radical nephrectomy T2 group (ORNT2, n=29).

Results

Compared with the LRNT1 group, the LRNT2 group only had larger tumors, but comparable operation time, blood loss, variation in the creatinine value (ΔCr), analgesics requirements, time to ambulate and diet, hospital stay and complication rates. The tumor sizes were similar in the two groups (p=0.260). However, the LRNT2 group had shorter operation time (p=0.039), lesser blood loss (p=0.044), ΔCr (p=0.027), analgesic requirements (p<0.001) and time to ambulation, diet and hospital stay (p<0.001, all).

Conclusions

A LRN for stage T2 renal tumors is feasible and efficacious. The surgical outcomes were comparable with those of a LRN for stage T1 tumors, with the advantages of decreased blood loss and more rapid recovery over that of an ORN for comparable tumors greater than 7cm in size.

Figures and Tables

Table 1
Clinical characteristics
kju-47-1139-i001

LRNT1: laparoscopic radical nephrectomy for clinical stage T1 renal cell carcinoma, LRNT2: laparoscopic radical nephrectomy for clinical stage T2 renal cell carcinoma, ORNT2: open radical nephrectomy for clinical stage T2 renal cell carcinoma

Table 2
Perioperative results (LRNT1 vs. LRNT2)
kju-47-1139-i002

LRNT1: laparoscopic radical nephrectomy for clinical stage T1 renal cell carcinoma, LRNT2: laparoscopic radical nephrectomy for clinical stage T2 renal cell carcinoma

Table 3
Perioperative results (LRNT2 vs. ORNT2)
kju-47-1139-i003

LRNT2: laparoscopic radical nephrectomy for clinical stage T2 renal cell carcinoma, ORNT2: open radical nephrectomy for clinical stage T2 renal cell carcinoma

Table 4
Complications
kju-47-1139-i004

LRNT1: laparoscopic radical nephrectomy for clinical stage T1 renal cell carcinoma, LRNT2: laparoscopic radical nephrectomy for clinical stage T2 renal cell carcinoma, ORNT2: open radical nephrectomy for clinical stage T2 renal cell carcinoma

Table 5
Recurrences
kju-47-1139-i005

LRNT1: laparoscopic radical nephrectomy for clinical stage T1 renal cell carcinoma, LRNT2: laparoscopic radical nephrectomy for clinical stage T2 renal cell carcinoma, ORNT2: open radical nephrectomy for clinical stage T2 renal cell carcinoma

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