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Laparoscopic versus open partial nephrectomy for clinical T1 renal masses: no impact of surgical approach on perioperative complications and long-term postoperative quality of life

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Abstract

Objectives

Beyond oncological safety, consideration of 30-day complications according to Clavien–Dindo, as well as postoperative quality of life (QoL) after nephron-sparing surgery for clinical T1 renal masses, represents important factors for treatment decision counseling. The objective of this study was to compare the effect of laparoscopic versus open partial nephrectomy (LPN vs. OPN) on 30-day complications and long-term postoperative QoL for clinical T1 renal masses.

Methods

Retrospective, longitudinal analysis of 293 patients treated with either LPN versus OPN for T1 renal masses. The investigated endpoints were 30-day Clavien–Dindo complications and health-related QoL (EORTC QLQ-C30). Respectively, logistic and linear regression models analyzed the effect of surgical partial nephrectomy approach on endpoints.

Results

Overall complication rates were similar in patients undergoing OPN or LPN (16.1 vs. 14.6 %, p = 0.8). Significantly less major complications (2.4 vs. 10.4 %, p = 0.025) occurred after LPN. Despite a shorter convalescence period for LPN patients (p = 0.035), in uni- and multivariable analyses, surgical approach was not associated with 30-day complications nor long-term differences in QoL (all p > 0.05).

Conclusions

Despite a faster recovery time after LPN, our findings suggest that LPN and OPN are equivalent with regard to 30-day Clavien–Dindo complication rates and long-term QoL.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

The authors confirm that the study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All patients gave their informed consent prior to their inclusion in the study.

Author information

Authors and Affiliations

  1. Department of Urology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

    Andreas Becker, Lea Pradel, Luis Kluth, Marianne Schmid, Christian Eichelberg, Sascha Ahyai, Roland Dahlem, Jens Hansen, Michael Rink, Margit Fisch & Felix K. H. Chun

  2. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada

    Andreas Becker

  3. Division of Urology, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Quoc Trinh

  4. Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Quoc Trinh

  5. Department of Urology, Kantonsspital Aarau, Aarau, Switzerland

    Daniel Seiler

  6. Department of Urology, Vivantes Auguste-Victoria-Klinikum, Berlin, Germany

    Mario Zacharias

  7. Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Anja Mehnert & Corinna Bergelt

Authors
  1. Andreas Becker
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  2. Lea Pradel
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  3. Luis Kluth
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  4. Marianne Schmid
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  5. Christian Eichelberg
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  6. Sascha Ahyai
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  7. Quoc Trinh
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  8. Daniel Seiler
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  9. Roland Dahlem
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  10. Jens Hansen
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  11. Michael Rink
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  12. Mario Zacharias
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  13. Anja Mehnert
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  14. Corinna Bergelt
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  15. Margit Fisch
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  16. Felix K. H. Chun
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Corresponding author

Correspondence to Andreas Becker.

Additional information

Andreas Becker and Lea Pradel have contributed equally to this manuscript.

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Becker, A., Pradel, L., Kluth, L. et al. Laparoscopic versus open partial nephrectomy for clinical T1 renal masses: no impact of surgical approach on perioperative complications and long-term postoperative quality of life. World J Urol 33, 421–426 (2015). https://doi.org/10.1007/s00345-014-1318-1

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  • DOI: https://doi.org/10.1007/s00345-014-1318-1

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