Prospective analysis of laparoscopic versus open radical nephrectomy for renal tumours more than 7 cm

• Main Authors: Mohd Mubashir Ali Khan, Rajkumar Ashokkumar Patel, Nitesh Jain, Arunkumar Balakrishnan, Murali Venkataraman
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Journal of Minimal Access Surgery
• Subjects: Clinical stage T2 renal tumour; laparoscopic radical nephrectomy; renal cell carcinoma
• Online Access: http://www.journalofmas.com/article.asp?issn=0972-9941;year=2019;volume=15;issue=1;spage=14;epage=18;aulast=Khan
• ISSN: 0972-9941; 1998-3921

Aims: To analyse the feasibility of laparoscopic radical nephrectomy (LRN) for renal tumours >7 cm and to compare the operative and oncologic outcomes with open radical nephrectomy (ORN). Settings and Design: This was a prospective, observational, comparative study. Subjects and Methods: The study was conducted at a tertiary care super-speciality hospital. All the patients who underwent radical nephrectomy for >7 cm renal tumours during a period of 2 years (April 2012 to May 2014) were included in the study. Thirty patients were included in each ORN and LRN group. Pre-operative, intra-operative and post-operative data for all these patients were collected and analysed. Statistical Analysis Used: Statistical Package for the Social Sciences (SPSS, version 11.0 for Windows, Chicago, IL). Results: Mean age of patients in ORN and LRN groups was 57.3 ± 6.1 years and 54.9 ± 5.7 years, respectively (P = 0.220). As compared to ORN, LRN had less drop in post-operative haemoglobin (1.39 ± 0.55 g/dl vs. 4.07 ± 1.023 g/dl, P < 0.05), less drop in haematocrit value (4.7 ± 3.25% vs. 9.5 ± 5.13%, P < 0.05), less analgesic requirement for tramadol hydrochloride (165 ± 74.5 mg vs. 260 ± 181.66 mg) and less mean hospital stay (4.2 days vs. 6.1 days, P < 0.05). There was no statistically significant difference in post-operative complication rate and recurrence-free survival over a median follow-up of 17 months (93.9% – LRN vs. 90% – ORN) Conclusions: LRN for large renal tumours is feasible and achieves oncologic outcomes similar to that obtained with ORN.