A Comparative Study Of Retroperitoneoscopic And Open Radical Nephrectomy For Large Renal Cell Carcinoma

OBJECTIVE:To evaluate the clinical efficacy and safety of retroperitoneoscopic radical nephrectomy for treatment of large renal tumors (more than 7 cm) as compared with open surgery.Methods:20 patients received RPN and 28 patients received ON were retrospectively analyzed from Jul.2007 to Jul.2010. The operation time, blood loss during operation, hospital stay and complication after sugery were compared in all the patients of these two groups.Results:The operative time in the ON group(160±47 min) was significantly shorter than that in the RPN group(230±89 min), P<0.01. The estimated blood loss in the RPN group(205±87 ml) was also significantly less than in the ON group(462±186 ml), P<0.01. The incision length was significantly longer in the ON group(1±5 cm) than in the RPN group(6±1cm), P<0.01. Patients in RPN group experienced significantly shorter bowel function recovery and earlier duration of drainage than those in the ON group after operation. All patients were followed up for 6-28 months,1 patient in the RPN group developed lung metastasis, and 1 developed incison implantation metastasis. In the ON group.1 patient developed liver metastasis and 1 developed lung meatstasis. No severe perioperative complications occurred.Conclusion:Despite the longer operative time, RPN was an effective treatment option for large renal tumors. It achieved similar to that obtained with ON. However, there may be bias, more long-term followup trials are required.