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Modified laparoscopic simple enucleation with single-layer suture technique versus standard laparoscopic partial nephrectomy for treating localized renal cell carcinoma

  • Urology - Original Paper
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Abstract

Objectives

To compare modified laparoscopic simple enucleation (MLSE) and standard laparoscopic partial nephrectomy (SLPN) for treating localized renal cell carcinoma in our large institutional experience.

Methods

We evaluated 385 consecutive patients who underwent MLSE or SLPN for renal tumors in our institution from January 2013 to December 2015 in terms of perioperative pathological and oncologic outcome variables. During MLSE, the single-layer suture technique was performed for renal reconstruction.

Results

In total, 280 patients underwent MLSE and 105 underwent SLPN. Mean operative time was 182.1 and 192.8 min, respectively (p = 0.078). Warm ischemic time was significantly lower in the MLSE than SLPN group (23.2 vs 25.4 min; p = 0.004). The estimated blood loss was similar (p = 0.537). Tumor bed suturing was performed in 9.3 and 82.9% of MLSE and SLPN cases (p = 0.000). No hilar clamping was needed for 29 MLSE patients (10.4%) and 4 SLPN patients (3.8%) (p = 0.041). Grade III complications were reported in 5 (1.8%) MLSE patients and 7 (6.6%) SLPN patients (p = 0.034). The incidence of positive surgical margins was comparable between the MLSE and SLPN groups (1.8 and 5.7%, p = 0.086). After a median follow-up of 18 months, recurrence did not differ between the 2 groups: 9 (3.2%) MLSE patients and 4 (3.8%) SLPN patients (p = 1.000).

Conclusions

MLSE may confer shorter warm ischemic time, almost no need for tumor bed suturing and less grade III complications than SLPN, with similar oncologic outcomes. MLSE may be safe and acceptable for patients undergoing partial nephrectomy.

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Author notes

    Authors and Affiliations

    1. Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China

      Qun Lu, Xiaozhi Zhao, Changwei Ji, Guangxiang Liu, Shiwei Zhang, Xiaogong Li, Weidong Gan & Hongqian Guo

    2. School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China

      Suhan Guo

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    1. Qun Lu
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    2. Xiaozhi Zhao
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    3. Changwei Ji
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    4. Suhan Guo
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    5. Guangxiang Liu
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    6. Shiwei Zhang
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    7. Xiaogong Li
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    8. Weidong Gan
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    9. Hongqian Guo
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    Correspondence to Hongqian Guo.

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    The authors declare that they have no conflict of interest.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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    Informed consent was obtained from all individual participants included in the study.

    Additional information

    Qun Lu and Xiaozhi Zhao have contributed equally to this work.

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    Lu, Q., Zhao, X., Ji, C. et al. Modified laparoscopic simple enucleation with single-layer suture technique versus standard laparoscopic partial nephrectomy for treating localized renal cell carcinoma. Int Urol Nephrol 49, 239–245 (2017). https://doi.org/10.1007/s11255-016-1470-1

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    • DOI: https://doi.org/10.1007/s11255-016-1470-1

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