Surgery For Localized Renal Cell Carcinoma: A Comparison Of Clinical Outcomes

Objective: To compare the surgical characteristics and clinical outcomes ofradical nephrectomy and nephron-sparing surgery in either laparoscopic or open forlocalized renal cell carcinoma.Methods: we retrospectively analyzed the clinical data of86patients withlocalized renal carcinoma, who were treated with surgery.30received LRN,28received ORN,21received OPN,7received LPN. The age, gender, size, local ofcarcinoma, operation time, renal warm ischemia, intraoperative blood loss, drainagetime, postoperative recovery time of intestinal function, ambulation after operation,postoperative hospital stay, complications(bleeding, urine leak, kidney functionfailure),tumor mortality, recurrence and so on were compared between LRN andORN, NSS and RN, LPN and OPN.Results: There are no significant differences in the demographics of LRN vsORN and LPN vs OPN, NSS vs RN,(P＞0.05), so they are comparable. LRN vs ORN:intraoperative blood loss, drainage time, postoperative recovery time of intestinalfunction, ambulation after operation, hospital stay,Group LRN is superior to groupORN, statistic differences are significant (P＜0.05),the operation time is longer thanORN, but no significant statistic differences (P＞0.05). All cases were followed upfor2~36months, no tumor recurrence and metastasis. LPN vs OPN:LPN is betterthan OPN in the intraoperative blood loss, postoperative recovery time of intestinalfunction, ambulation after operation and hospital stay, statistic differences aresignificant (P＜0.05). renal warm ischemia in group LPN is longer than group OPN,statistic differences are significant (P＜0.05). drainage time in group LPN is shorterthan group OPN, operation time is longer than group OPN,but no significant statisticdifferences (P＞0.05). there is no positive surgery margin both LPN and OPN, allcases were followed up for3~34months, no tumor recurrence and metastasis. NSS VsRN:RN is better than NSS in the complications, but NSS is better than RN in protectthe kidney function; NSS cases were followed up for3~34months, RN cases were followed up2~36months, no tumor recurrence and metastasis.Conclusion: laparoscopic has less blood loss, shorter hospital stay, fasterrecovery than open operation. In the premise of master of the LPN, LPN is a goodmethod for the early localized renal cell carcinoma.