A Comparative Study Of Retroperitoneal Laparoscopic And Open Nephron Sparing Surgery For Renal Cell Carcinoma

Objective In this study, we compared many aspects the two groups of RLNSS andONSS and acquired corresponding results, to further explicate the advantages anddisadvantages of both methods in therapying kidney cancer, to provide a reference for clinicaldoctors.Methods Retrospective analysis of39cases of renal cell carcinoma-patientsexperienced with nephron-sparing surgery, in Department of Urology of Ningxia MedicalUniversity General Hospital from January1,2009to December31,2013, including24caseswith open nephron-sparing surgery and15cases with retroperitoneal laparoscopicnephron-sparing surgery, we compare the operative time，intraoperative blood loss，the rate ofintraoperative blood transfusion，warm ischemic time，gastrointestinal postoperative recoverytime，drainage tube removed time，post operation hospitalization duration， hemorrhage rate，postoperative complications，the total cost of hospitalization. Patients were followed up for2to20months，comparison of two groups of renal cell carcinoma recurrence and survival.Results All operations were completed successfully，no patients died. The span time ofdrainage tube inserted is no significant difference between ONSS group and LNSSgroup(P=0.276),The LNSS group, compared ONSS group, has less operative time, less bloodloss, shorter hospitalization and gastrointestinal postoperative recovery time, however TheRLNSS group has more warm ischemic time and more cost than ONSS group, the two groupshave significant difference(P=0.016),Two groups of kidney function in the preoperative,postoperative1day,3days have no significant difference(P>0.05). Conclusions Despite the RLNSS learning, performed more difficultly,need more time,LNSS using minimally invasive techniques on the basis of the ONSS retain nephron-sparing,to reduce the burden of contralateral kidney, whatmore shorter operative time, less blood loss,shorter intraoperative-hospitalized, faster recovery of bowel function et al.RLNSS is a safe,effective and-minimally invasive surgery, under appropriate indications, limitations of less4cm kidney carcinoma can choose laparoscopic nephron-sparing surgery, we consider that canreduce renal vascular clamping and intraoperative hemostasis time by the clinical experienceaccumulation and exploitation of surgeons,laparoscopic surgery operation further improveand the development of new equipment. The study needs further and variety randomizedcontrolled research.