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    Korean J Urol. 2008 Mar;49(3):203-207. Korean.
    Published online Mar 31, 2008.
    https://doi.org/10.4111/kju.2008.49.3.203
    Copyright © 2008 The Korean Urological Association
    Original Article

    Surgical Results of Laparoscopic Radical Nephrectomy according to Tumor Size in Renal Cell Carcinomas

    Jea Whan Lee, Ill Young Seo, and Joung Sik Rim
      • Department of Urology, Wonkwang University School of Medicine, Iksan, Korea.
    Received December 18, 2007; Accepted February 12, 2008.

    Abstract

    Purpose

    Laparoscopic surgery has been generalized for the treatment of localized renal cell carcinoma (RCC). Recently, laparoscopic radical nephrectomy for an RCC over the pT2 stage has gained rapid momentum as an effective surgery for treatment. We evaluated the possibility of the use of laparoscopic surgery for a large RCC, using the surgical results according to tumor size.

    Materials and Methods

    Between June 2003 and June 2007, a total of 46 patients that under underwent a laparoscopic radical nephrectomy for RCC were divided into three groups according to tumor size: group 1 (n=16, tumor size ≤4cm), group 2 (n=15, tumor size 4cm<n≤7cm), and group 3 (n=15, tumor size >7cm). The surgical outcomes and perioperative morbidities were evaluated retrospectively, and were compared for each group.

    Results

    The transfusion rate for group 3 patients was higher than for the other groups (group 1: 0%, group 2: 13.3%, group 3: 26,7%). However, the mean operative time (group 1: 154.3 minutes, group 2: 158.4 minutes, group 3: 197.9 minutes), postoperative initiative time to ambulate (group 1: 1.88 days, group 2: 2.00 days, group 3: 1.87 days) postoperative initiative time to diet (group 1: 1.38 days, group 2: 1.53 days, group 3: 1.53 days), total hospital stay (group 1: 7.94 days, group 2: 8.47 days, group 3: 8.20 days) and complication rate (group 1: 12.5%, group 2: 13.3%, group 3: 13.3%) were similar for patients in the three groups. Pathological results indicated that all cases showed a renal cell carcinoma with a negative surgical margin.

    Conclusions

    There were no differences in the operative and postoperative results of the performance of laparoscopic radical nephrectomy according to tumor size, except for the transfusion rate. If the use of the technique and experience accumulate, laparoscopic radical nephrectomy will be feasible for all localized RCC regardless of tumor size.

    Keywords
    Renal cell carcinoma; Laparoscopy; Nephrectomy

    Tables

    Table 1
    Clinical characteristics

    Table 2
    Operative results

    Table 3
    Operative results (statistical results)

    Table 4
    Pathological results

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    MeSH Terms
    Carcinoma, Renal Cell
    Humans
    Laparoscopy
    Nephrectomy
    Retrospective Studies
    Salicylates
    Metrics
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