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    Korean J Urol. 2006 Nov;47(11):1144-1148. Korean.
    Published online Nov 30, 2006.
    https://doi.org/10.4111/kju.2006.47.11.1144
    Copyright © 2006 The Korean Urological Association
    Original Article

    Laparoscopic Radical Nephrectomy: Results and Oncological Outcome

    Hyun Sop Choe, Jun Ha Lee, Seong Hu Hong and Tae Kon Hwang
      • Department of Urology, The Catholic University of Korea, Seoul, Korea.
    • Corresponding author (Email: tkhwang@catholic.ac.kr )
    Received May 26, 2006; Accepted September 26, 2006.

    Abstract

    Purpose

    A laparoscopic radical nephrectomy is known to cause less morbidity than a traditional open radical nephrectomy. In our institution, the laparoscopic approach, with intact specimen removal, has become the standard technique for radical nephrectomies. Herein, we report the results and oncological outcome of the experience of a single center.

    Materials and Methods

    We reviewed 68 transperitoneal laparoscopic radical nephrectomies, performed for suspected renal cell carcinoma between December 1999 and June 2006. All data were collected from the patient's medical records.

    Results

    The mean tumor size, surgical time and estimated blood loss were 4.82cm (1.7-14), 228.5 min (120-480) and 409.1cc (32-1,312), respectively. Conversion to open surgery was required in one case due to Endo-GIA malfunction, and conversion to hand-assisted surgery was performed in one case. The histological findings were pT1, pT2 and pT3 in 40 (59.7%), 9 (13.4%) and 18 patients (26.9%), respectively. In one case, the histology confirmed a non-malignant disease. The follow-up period was from 3 to 80 months (median 18). Distant metastasis was observed in 2 cases, but there was no local recurrence or port metastasis.

    Conclusions

    A laparoscopic radical nephrectomy is a safe and feasible treatment for localized renal cell carcinomas. Longer follow-up and large scale studies are necessary to evaluate the long-term survival and disease-free rates, and confirm the effectiveness of performing a radical laparoscopic nephrectomy.

    Keywords
    Renal cell carcinoma; Laparoscopy; Nephrectomy

    Figures

    Fig. 1
    The bar graph shifting during 68 cases. Note: the more experience gathers, the larger the tumor indicates. There are significant differences between the two groups (p=0.037, independent-sample t-test).

    Fig. 2
    Kaplan-Meier curve indicating the proportions free of disease recurrences. The disease-free survival rate is 96.5±2.4% (95% CI). CI: confidence interval.

    Tables

    Table 1
    Patient characteristics

    Table 2
    Operative data and postoperative course

    Table 3
    Pathological results

    Table 4
    Survival analysis after a laparoscopic radical nephrectomy

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    MeSH Terms
    Carcinoma, Renal Cell
    Conversion to Open Surgery
    Follow-Up Studies
    Humans
    Laparoscopy
    Medical Records
    Neoplasm Metastasis
    Nephrectomy*
    Operative Time
    Recurrence
    Metrics
    Share
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