Comparison of Laparoscopic and Open Partial Nephrectomies in T1a Renal Cell Carcinoma: A Korean Multicenter Experience
박홍주, 서일영, 황태곤, 권태균, 이완, 김용준, 전승현, 김현회, 오태희, 강석호, 권동득, 변석수, 나군호, 서성일, 이승배, 전윤수, 최윤희, 박수경,
소속 상세정보
박홍주 ( Park Hong-Zoo )
강원대학교 의과대학 비뇨기과학교실
서일영 ( Seo Ill-Young )
원광대학교 의과대학 비뇨기과학교실
황태곤 ( Hwang Tae-Kon )
가톨릭대학교 의과대학 비뇨기과학교실
권태균 ( Kwon Tae-Gyun )
경북대학교 의과대학 비뇨기과학교실
이완 ( Lee Wan )
부산대학교 의과대학 비뇨기과학교실
김용준 ( Kim Yong-June )
Chungbuk National University
전승현 ( Jeon Seung-Hyun )
경희대학교 의과대학 비뇨기과학교실
김현회 ( Kim Hyeon-Hoe )
서울대학교 의과대학 비뇨기과학교실
오태희 ( Oh Tae-Hee )
성균관대학교 의과대학 비뇨기과학교실
강석호 ( Kang Seok-Ho )
고려대학교 의과대학 비뇨기과학교실
권동득 ( Kwon Dong-Deuk )
전남대학교 의과대학 비뇨기과학교실
변석수 ( Byun Seok-Soo )
서울대학교 의과대학 비뇨기과학교실
나군호 ( Rha Koon-Ho )
연세대학교 의과대학 비뇨기과학교실
서성일 ( Seo Seong-Il )
성균관대학교 의과대학 비뇨기과학교실
이승배 ( Lee Seung-Bae )
서울대학교 의과대학 비뇨기과학교실
전윤수 ( Jeon Yoon-Soo )
순천향대학교 의과대학 비뇨기과학교실
최윤희 ( Choi Yun-Hee )
서울대학교병원 의학연구협력센터
박수경 ( Park Sue-Kyung )
서울대학교병원 의학연구협력센터
KMID : 0358320100510070467
Abstract
Purpose: We analyzed a series of patients who had undergone laparoscopic partial nephrectomies (LPNs) and open partial nephrectomies (OPNs) to compare outcomes of the two procedures in patients with pathologic T1a renal cell carcinomas (RCCs).
Materials and Methods: From January 1998 to May 2009, 417 LPNs and 345 OPNs were performed on patients with small renal tumors in 15 institutions in Korea. Of the patients, 273 and 279 patients, respectively, were confirmed to have pT1a RCC. The cohorts were compared with respect to demographics, peri-operative data, and oncologic and functional outcomes.
Results: The demographic data were similar between the groups. Although the tumor location was more exophytic (51% vs. 44%, p=0.047) and smaller (2.1 cm vs. 2.3 cm, p=0.026) in the LPN cohort, the OPN cohort demonstrated shorter ischemia times (23.4 min vs. 33.3 min, p<0.001). The LPN cohort was associated with less blood loss than the OPN cohort (293 ml vs. 418 ml, p<0.001). Of note, two patients who underwent LPNs had open conversions and nephrectomies were performed because of intra-operative hemorrhage. The decline in the glomerular filtration rate at the last available follow-up (LPN, 10.9%; and OPN, 10.6%) was similar in both groups (p=0.8). Kaplan-Meier estimates of 5-year local recurrence-free survival (RFS) were 96% after LPN and 94% after OPN (p=0.8).
Conclusions: The LPN group demonstrated similar rates of recurrence-free survival, complications, and postoperative GFR change compared with OPN group. The LPN may be an acceptable surgical option in patients with small RCC in Korea.
키워드
Glomerular filtration rate;Kidney neoplasms;Nephrectomy;Outcomes assessment
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