Skip to main content
SpringerLink
Log in

Laparoskopische Nierenteilresektion bei Nierentumoren

Zeit für einen neuen Standard?

Laparoscopic partial nephrectomy for renal tumors

Time for a new standard?

  • Originalien
  • Published:
Der Urologe Aims and scope Submit manuscript

Zusammenfassung

Fragestellung

Ziel der Studie war die an unserer Klinik durchgeführten laparoskopischen Nierenteilresektionen (LPN) mit aktuellen Studien zur Nierenteilresektion zu vergleichen.

Patienten und Methoden

Im Zeitraum von 03/2006 bis 01/2014 wurden in unserer Klinik 280 laparoskopische Nierenteilresektionen durchgeführt. Wir evaluierten Alter und Geschlecht der Patienten sowie Operationsdauer, Ischämiezeit, Dauer des Krankenhausaufenthalts und Komplikationsraten mit Hilfe der Clavien-Dindo-Klassifikation.

Ergebnis

In unserem Kollektiv waren die Patienten im Mittel 61,6 ± 12,4 Jahre alt. Der Median der Operationszeit betrug 134 ± 51 min. 30 % der Operationen wurden in Zero-Ischämie-Technik durchgeführt. Die warme Ischämiezeit (WIT) betrug im Mittel 19,9 ± 9,8 min. Die WIT der 50 zuletzt durchgeführten LPN betrug 13 ± 7 min. Nach 15 % der Operationen wurden Komplikationen dokumentiert.

Schlussfolgerung

Die laparoskopische Nierenteilresektion stellt eine kurative Therapieoption des Nierenzellkarzinoms dar, die der offenen Nierenteilresektion ebenbürtig ist, jedoch mit einer geringeren Morbidität einhergeht.

Abstract

Purpose

Our aim was to evaluate the laparoscopic partial nephrectomies (LPN) performed at our hospital and compare the results with those from other current studies on partial nephrectomy.

Patients and methods

Between March 2006 and January 2014, 280 patients were treated with LPN in our hospital. We evaluated age, sex, and surgical parameters like operating time, warm ischemia time (WIT), hospital stay, complications, tumor staging, grading, and size

Results

The patients were 61.6±12.4 years old. The median operating time for LPN was 134±51 min. A total of 30% of the operations were treated using the zero ischemia technique. The WIT was 19.9±9.8 min. The WIT of the last 50 LPN performed was 13±7 min. Complications were documented in 15% of the LPNs.

Conclusion

LPN is a curative treatment option for the renal cell carcinoma similar to open partial nephrectomy; however, laparoscopy is associated with lower morbidity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Aron M, Gill I (2007) Minimally invasive nephron-sparing surgery (MINSS) for renal tumour. Eur Urol 51(2):348–357

    Article  PubMed  Google Scholar 

  2. Benway BM, Bhayani SB, Rogers CG et al (2009) Robot assisted partial nephrectomy versus laparoscopic partial nephrectomy for renal tumors: a multi-institutional analysis of perioperative outcomes. J Urol 182(3):866–872. doi:10.1016/j.juro.2009.05.037

    Article  PubMed  Google Scholar 

  3. Couapel JP, Bensalah K, Bernhard JC et al (2013) Is there a volume-outcome relationship for partial nephrectomy? Eur Urol 63(4):759–765

    Article  Google Scholar 

  4. Deane LA, Lee HJ, Box GN et al (2008) Robotic versus standard laparoscopic partial/wedge nephrectomy: a comparison of intraoperative and perioperative results from a single institution. J Endourol 22(5):947–952

    Article  PubMed  Google Scholar 

  5. Fornara P, Doehn C, Friedrich HJ, Jocham D (2001) Non-randomized comparison of open flank versus laparoscopic nephrectomy in 249 patients with benign renal disease. Eur Urol 40(1):24–31

    Article  CAS  PubMed  Google Scholar 

  6. Gill I, Eisenberg M, Aron M et al (2011) „Zero ischemia“ partial nephrectomy: novel laparoscopic and robotic technique. Eur Urol 59(1):128–134

    Article  PubMed  Google Scholar 

  7. Haber G, White W, Crouzet S et al (2010) Robotic versus laparoscopic partial nephrectomy: single-surgeon matched cohort study of 150 Patients. Urology 76(3):754–758

    Article  PubMed  Google Scholar 

  8. Heidenreich A (2011) Operative Therapie des Nierenzellkarzinoms. Urologe 50:208–215

    Article  PubMed  Google Scholar 

  9. Janetschek G (2012) Nierenteilresektion – pro Laparoskopie. Urologe 51(5):646–649

    Article  CAS  PubMed  Google Scholar 

  10. Kreshover JE, Richstone L, Kavoussi LR (2013) Renal cell recurrence for t1 tumors after laparoscopic partial nephrectomy. J Endourol 27(12):1468–1470

    Article  PubMed  Google Scholar 

  11. Kural A, Atug F, Tufek I, Akpinar H (2003) Robot-assisted partial nephrectomy versus laparoscopic partial nephrectomy: comparison of outcomes. J Endurol 23(9):1491–1497

    Article  Google Scholar 

  12. Ljungberg B, Cowan NC, Hanbury DC et al (2010) EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol 58(3):398–406

    Article  PubMed  Google Scholar 

  13. Longoa N, Minervinib A, Antonellic A et al (2014) Simple enucleation versus standard partial nephrectomy for clinical T1 renal masses: perioperative outcomes based on a matched-pair comparison of 396 patients (RECORd project). Eur J Surg Oncol 40(6):762–768

    Article  Google Scholar 

  14. Lucas SM, Mellon MJ, Erntsberger L, Sundaram CP (2012) A comparison of robotic, laparoscopic and open partial nephrectomy. JSLS 16(4):581–587

    Article  PubMed Central  PubMed  Google Scholar 

  15. Nadu A, Goldberg H, Lubin M, Baniel J (2013) Laparoscopic partial nephrectomy (LPN) for totally intrarenal tumours. BJU Int 112(2):82–86

    Article  Google Scholar 

  16. Pierroa D, Tartagliaa N, Aresub L et al (2013) Laparoscopic partial nephrectomy for endophytic hilar tumors: feasibility and outcomes. Eur J Surg Oncol (Epub ahead of print)

  17. Ploussard G, Haddad R, Kovac E et al (2013) Robot assisted laparoscopic partial nephrectomie: early single Canadian institution experience. Can Urol Assoc J 7(9–10):348–354

  18. Schostak M, Wloch H, Müller M et al (2014) Optimizing open live-donor nephrectomy – long-term donor outcome. Clin Transplant 18:301–305

    Article  Google Scholar 

  19. Shao P, Qin C, Yin C et al (2011) Laparoscopic partial nephrectomy with segmental renal artery clamping: technique and clinical outcomes. Eur Urol 59(5):849–855

    Article  PubMed  Google Scholar 

  20. Springer C, Hoda MR, Fajkovic H et al (2013) Laparoscopic vs open partial nephrectomy for T1 renal tumours: evaluation of long‐term oncological and functional outcomes in 340 patients. BJU Int 111(2):281–288

    Article  PubMed  Google Scholar 

  21. Tan H, Norton E, Ye Z et al (2012) Long-term survival following partial vs radical nephrectomy among older patients with early-stage kidney cancer. JAMA 307(15):1629–1635

    Article  CAS  PubMed  Google Scholar 

  22. Thompsona R, Laneb B, Lohsea C et al (2010) Every minute counts when the renal hilum is clamped during partial nephrectomy. Eur Urol 58(3):340–345

    Article  Google Scholar 

  23. Wang H, Zhou L, Guo J et al (2014) Mini-flank supra-12th rib incision for open partial nephrectomy compared with laparoscopic partial nephrectomy and traditional open partial nephrectomy. PLoS One 9(2):89155

    Article  Google Scholar 

  24. Weight C, Larson B, Fergany A et al (2010) Nephrectomy induced chronic renal insufficiency is associated with increased risk of cardiovascular death and death from any cause in patients with localized cT1b renal masses. J Urol 183(4):1317–1323

    Article  PubMed  Google Scholar 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. S. Bier, T. Todenhöfer, S. Aufderklamm, J. Hennenlotter, J. Mischinger, A. Sim, J. Böttge, S. Rausch, O. Halalsheh, A. Stenzl, G. Gakis und C. Schwentner geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Klinik für Urologie, Eberhard-Karls-Universität Tübingen, Hoppe-Seyler Straße 3, 72076, Tübingen, Deutschland

    S. Bier, T. Todenhöfer, S. Aufderklamm, J. Hennenlotter, J. Mischinger, A. Sim, J. Böttge, S. Rausch, O. Halalsheh, A. Stenzl, G. Gakis &  C. Schwentner FEBU

Authors
  1. S. Bier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Todenhöfer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Aufderklamm
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Hennenlotter
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Mischinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Sim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. Böttge
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S. Rausch
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. O. Halalsheh
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. A. Stenzl
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. G. Gakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. C. Schwentner FEBU
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Schwentner FEBU.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bier, S., Todenhöfer, T., Aufderklamm, S. et al. Laparoskopische Nierenteilresektion bei Nierentumoren. Urologe 54, 826–831 (2015). https://doi.org/10.1007/s00120-014-3656-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00120-014-3656-4

Schlüsselwörter

Keywords

Search

Navigation