Photo Credit: Yakobchuk Olena

The following is a summary of “A Contemporary Comparison of Laparoscopic versus Open Partial Nephrectomy for Renal Cell Carcinoma,” published in the March 2024 issue of Urology by Nicaise et al.

This study aims to provide a comprehensive analysis of the surgical and oncologic outcomes in patients undergoing open partial nephrectomy (OPN) compared to laparoscopic partial nephrectomy (LPN) for the treatment of renal cell carcinoma (RCC).

A retrospective analysis was conducted using data from the institutional RCC database, encompassing patients who underwent partial nephrectomy for RCC between 1997 and 2018. The operating urologist, based on individual practice patterns and training history, determined the choice of surgical technique. Various outcomes, including preoperative, perioperative, and postoperative parameters, as well as pathologic outcomes and rates of disease recurrence, were analyzed.

Out of 1,088 patients who underwent partial nephrectomy during the specified period, 631 patients who underwent 647 unique procedures (162 OPN and 485 LPN) were included after applying exclusion criteria. Baseline characteristics, preoperative parameters, and pathologic features did not show statistically significant differences between the two groups. Laparoscopic cases exhibited shorter surgical times (185 vs. 205 minutes, p = 0.013), lower estimated blood loss (150 vs. 250 mL, p < 0.001), and longer ischemia times (21 vs. 19 minutes, p = 0.005) compared to open procedures. LPN was associated with a shorter length of hospital stay (2 vs. 4 days, p < 0.001), fewer overall complications (p < 0.001), and a lower risk of developing metastases (1.65% vs. 4.94%, p = 0.0499). Local recurrence rates did not significantly differ between the two techniques (1.24% vs. 3.09%, p = 0.193). Additionally, postoperative renal function was comparable between the two cohorts.

The findings suggest that long-term oncologic outcomes do not significantly differ between LPN and OPN, with similar patient and tumor characteristics observed in both groups. LPN demonstrated advantages in reduced blood loss, shorter hospital stays, and a lower overall complication rate. Moreover, there were no significant differences in renal function postoperatively between the two surgical approaches.

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01423-w