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    Korean J Urol. 2007 Mar;48(3):259-264. Korean.
    Published online Mar 31, 2007.
    https://doi.org/10.4111/kju.2007.48.3.259
    Copyright © 2007 The Korean Urological Association
    Original Article

    Comparison of Laparoscopic Radical Nephrectomy with Open Radical Nephrectomy

    Tae Hyo Kim, Won Yeol Cho, Jae Jin Kwak, Jin Han Yoon and Gyung Tak Sung
      • Department of Urology, College of Medicine, Dong-A University, Busan, Korea.
    • Corresponding author (Email: sunggt@daunet.donga.ac.kr )
    Received November 15, 2006; Accepted January 10, 2007.

    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

    Fig. 1
    The renal artery and vein are exposed by retracting the lower pole of the kidney using a suction tip.

    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.

    Fig. 3
    En-block removal of the specimen containing the adrenal gland.

    Tables

    Table 1
    Patient demographics

    Table 2
    Operative outcomes

    Table 3
    Pathological and follow-up data

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    MeSH Terms
    Carcinoma, Renal Cell
    Diclofenac
    Humans
    Intraoperative Complications
    Kidney Neoplasms
    Laparoscopy
    Length of Stay
    Nephrectomy*
    Retrospective Studies
    Metrics
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