Kidney Injury, Kidney Ischemia, Kidney Neoplasms, Oncology, Renal Cancer, Renal Cell Carcinoma, Renal Neoplasm, Surgery, Urologic Cancer, Urologic Neoplasms
Conditions
Keywords
Laparoscopy, nephrometry score, partial nephrectomy, propensity score matching, radical nephrectomy
Brief summary
The study aims to investigate the rationale for LPN in patients with high-complexity renal tumors in terms of oncologic and functional outcomes.
Detailed description
From November 2009 to October 2018, 399 patients underwent LPN and 307 patients to laparoscopic radical nephrectomy (LRN). 41 patients with RENAL score ≥ 10 enrolled in LPN and 265 patients to the LRN group. Propensity score matching (matched by age, gender, clinical tumor stage, tumor size, baseline renal function, comorbidities such as diabetes mellitus (DM), hypertension (HT), coronary artery disease (CAD), and final tumor pathology of RCC) was used to reduce selection bias. Functional and oncological outcomes were compared between the two groups. After propensity score analysis, 39 patients in the LRN group were matched with 39 in the LPN group.
Interventions
PROCEDURElaparoscopic partial nephrectomy
Nephron sparing minimally invasive surgery
PROCEDURELaparoscopic radical nephrectomy
Completely removal of kidney by using laparoscopic surgery
Sponsors
Ondokuz Mayıs University
Samsun Liv Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients with complete data * Patients with single renal tumor on the effected side * Patients who approved the written consent form
Exclusion criteria
* Patients who not approved the written consent form * Patients with incomplete data * Patients with low or mild complexity renal tumors
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Operation time | at the end of the surgery | time from onset to complete of surgery |
| Blood loss | at the end of the surgery | amount of bleeding during surgery (mL) |
| warm ischemia time | at the and of the surgery | The clamp time of the renal artery and vein which is required to complete tumor excision and renorrhaphy |
| Postoperative complication | up to 3 months postoperatively | abnormal problmes that may be seen after surgery and require additional intervention, treatment or follow-up |
| functional outcomes | 1 year after the surgery | serum creatinine level (mg /dL) and estimated glomerular filtration rate (CKD Epidemiology Collaboration (CKD-EPI) equation) (mL/min/1.73 m2) |
| surigcal margin status | postoperative follow-up, through study completion, an average of 1 year | presence or absence of tumors at the surgical margin |
| CKD stage upgrading | postoperative follow-up, through study completion, an average of 1 year | evaluation of preoperative and postoperative renal functions according to chronic kidney disease stages |
| Oncological outomes | postoperative follow-up, through study completion, an average of 1 year | Presence or absence of local and/or distal tumor recurrence |
Countries
Turkey (Türkiye)
Outcome results
None listed