A Comparison Of The Clinical Effects Between Laparoscopic And Open Partial Nephrectomy

[Objectives]To compare the operative outcomes of laparoscopic partial nephrectomy with that of open partial nephrectomy.[Methods] Retrospective review of all patients who underwent laparoscopic partial nephrectomy and open partial nephrectomy between Augest2009and September2012was performed, except patients who had solitary kidney, multiple tumors, cold ischemia, or underwent partial nephrectomy without renal vessel clamped, stratifying65patients into two groups:37patients with laparoscopic partial nephrectomy and28patients with open partial nephrectomy. Perioperative parameters like demographic data, radius and location of renal mass, surgery duration, warm ischemia time, hospital stay, renal function and complications were analyzed and compared.[Results]Demographic data was comparable between group(P>0.05). Mean age of the patients from laparoscopic partial nephrectomy and open partial nephrectomy group are53.4±14.0and53.7±9.0respectively(P=0.519). Mean radius of renal masses are2.9±1.0cm and2.6±0.8cm respectively(P=0.108).The only patient with post-operative complication contract non-urologic aspiration pneumonitis(Clavien classification grade Ⅱ). The mean warm ischemia time was longer for those treated with laparoscopic partial nephrectomy(16.3±7.2min vs.23.9±6.7min, P<0.001). Cases of warm ischemia time longer than30min were0and3respectively in the two group. The Mean percentage of eGFR reduction were similar (10.1%vs.4.5%, P=0.033). No patients developed acute kidney injury or chronic kidney disease and none required transfusion perioperatively. Mean operative time (129.3±38.9min vs.152.6±29.5min, P=0.194) and mean hospital stay (15.9±3.5d vs.17.1±4.4d P=0.225) were similar between group. Mean estimated blood loss in the open partial nephrectomy group was slightly higher (201.5±101vs.186.9±102ml, P=0.554), but the difference was not statistical significant.[Conclusions]Laparoscopic partial nephrectomy is combined with less blood loss and invasiveness but warm ischemia time and operative time is longer in the laparoscopic partial nephrectomy. While the renal function outcomes are similar between the two techniques.