Retrospective Comparison of Laparoscopic Partial Nephrectomy Versus Laparoscopic Renal Cryoablation for Small (<3.5 cm) Cortical Renal Masses

医学 低温消融 肾切除术 失血 围手术期 肌酐 回顾性队列研究 外科 腹腔镜检查 泌尿科 内科学 烧蚀
作者
G. Michael Haramis,Joseph A. Graversen,Adam C. Mues,Ruslan Korets,Juan Carlos Rosales,Zhamshid Okhunov,Ketan K. Badani,Mantu Gupta,Jaime Landman
出处
期刊:Journal of Laparoendoscopic & Advanced Surgical Techniques [Mary Ann Liebert]
卷期号:22 (2): 152-157 被引量:21
标识
DOI:10.1089/lap.2011.0246
摘要

We compared perioperative and short-term outcomes of renal laparoscopic partial nephrectomy (LPN) and laparoscopic cryoablation (LCA) in patients with small (<3.5 cm) renal cortical neoplasms.A retrospective analysis from our prospectively established database was performed. We identified 92 patients with 95 lesions treated with LPN and 75 patients with 91 lesions treated with LCA.The LPN and LCA groups were comparable in mean tumor size and preoperative and postoperative creatinine level (P=.495, P=.953, and P=.101) respectively. Patients undergoing LPN were younger in age (58.8 versus 69.2 years, P<.001), had a higher mean estimated blood loss (168.4 versus 6 mL, P=.005), and had a prolonged mean operative time (151.6 versus 128.6 minutes, P=.01). Six complications occurred in the LCA group and 11 in the LPN group. The median follow-up time was 21.8 months for LPN and 14 months for LCA (P<.001). Two recurrences were detected in the LCA group, and 1 recurrence was reported after LPN.In the treatment of small renal cortical neoplasms with short-term follow-up, LPN and LCA seem to be equally effective. LCA offers decreased blood loss, shorter operative time, and less morbidity. Longer follow-up is required to establish oncologic efficacy.
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