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Kim, Cho, Kwak, Yoon, and Sung: Comparison of Laparoscopic Radical Nephrectomy with Open Radical Nephrectomy
Original Article
Korean Journal of Urology

Korean Journal of Urology 2007; 48(3): 259-264.

Published online: 31 March 2007

DOI: https://doi.org/10.4111/kju.2007.48.3.259

Comparison of Laparoscopic Radical Nephrectomy with Open Radical Nephrectomy

Tae Hyo Kim, Won Yeol Cho, Jae Jin Kwak, Jin Han Yoon, Gyung Tak Sung

Department of Urology, College of Medicine, Dong-A University, Busan, Korea.

Corresponding author (sunggt@daunet.donga.ac.kr)

Received 15 November 2006       Accepted 10 January 2007

Copyright © 2007 The Korean Urological Association

Abstract

Purpose

Laparoscopic surgery has become the standard surgical method within the urological community. This study was undertaken to evaluate the safety and efficacy of a standard laparoscopic radical nephrectomy (LRN) compared to an open radical nephrectomy (ORN) at a single medical center.

Materials and Methods

Between January 2003 and March 2006, laparoscopic radical nephrectomies for renal cell cancer were performed in 30 patients and the results of the laparoscopic radical nephrectomy were compared with those of the open counterpart. Surgical results, such as the operation time, estimated blood loss (EBL), transfusion rate, narcotic analgesic requirement, hospital stay, complications and pathologic results, were retrospectively reviewed and analyzed using the Student's t-test.

Results

There were no significant differences in the demographic data between the two groups. The pathological reports showed a clear cell type in 59 cases and a chromophobe type in 1 case. For the LRN and ORN groups, the mean operation times were 208 (120-320) vs. 206 min. (115-300) (p>0.05), EBL of 135 (100-200) vs. 318ml (100-2,000) (p=0.02), transfusion rates of 6.6 vs. 30%, narcotic analgesic requirements of 160 vs. 255mg diclofenac sodium, hospital stays of 6.7 vs. 10.5 days (p=0.04) and intraoperative complications in 0/30 (0%) vs. 2/30 cases (7%), respectively. The pathological surgical margins were all negative. The surgical and pathological parameters of the LRN group showed no significant differences to those of the ORN group, with the exception of the EBL and hospital stay.

Conclusions

Laparoscopic radical nephrectomy resulted in less blood loss, a shorter hospital stay and earlier rapid recovery than an open radical nephrectomy. In our opinion, laparoscopic surgery could be a standard surgical treatment in renal cell cancer.

Keywords: Renal cancer, Laparoscopy, Nephrectomy

Figures and Tables

Fig. 1
The renal artery and vein are exposed by retracting the lower pole of the kidney using a suction tip.
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Fig. 2
The renal artery was ligated using 10mm Weck clips and Titanium clips, and the renal vein was transected using an Endo-GIA staqpler.
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Fig. 3
En-block removal of the specimen containing the adrenal gland.
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Table 1
Patient demographics
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BMI: body mass index, ASA: American Society of Anesthesiologists

Table 2
Operative outcomes
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Data represented as mean (range). EBL: estimated blood loss, ns: not significant

Table 3
Pathological and follow-up data
kju-48-259-i003

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