Comparison Of Laparoscopic Radical And Partial Nephrectomy: Effects On Long Term Serum Creatinine

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology;  Clinical Trials / Drug Trials
Article Date: 30 Sep 2007 - 0:00 PDT

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UroToday.com- While laparoscopic partial nephrectomy (LPN) and laparoscopic radical nephrectomy (LRN) have been shown to be effective management in patients with localized renal tumor; there is limited data on the long term effect on postoperative renal function in these two patient groups. The University of Chicago clinical researchers compared 42 patients undergoing LPN to 55 patients undergoing LRN with a single, unilateral renal tumor and normal contra lateral kidney, and a serum creatinine less than 1.5 mg/dL. Preoperative, pathologic data and serum creatinine at least six months after surgery were compared between the two study groups. The tumors treated with LPN were significantly smaller than these in the LRN group. However, the mean age, body mass index, sex, tumor location, and serum creatinine (0.91 and 0.91 mg/dL, P = 0.93) were similar between the two groups. The laparoscopic partial nephrectomy procedure was on average 40 minutes longer than the LRN with a warm ischemia time of 37 minutes. The mean six-month serum creatinine was significantly greater for patients undergoing LRN (1.4 versus 1.0 mg/dL, P<0.001). Therefore, despite the warm ischemia time and longer operative time, patients with normal preoperative renal function and a normal contra-lateral kidney had a better chance of preservation of renal function and a reduced chance of developing renal insufficiency after LPN compared to LRN.

Zorn KC, Gong EM, Orvieto MA, Gofrit ON, Mikhail AA, Msezane LP, Shalhav AL

Urology. 69 (6):1035- 1039, June 2007
doi:10.1016/j.urology.2007.01.092

Reported by UroToday.com Contributing Editor Elspeth M. McDougall, M.D

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