Articles

Review – Kidney Cancer

Laparoscopic versus Open Partial Nephrectomy: Analysis of the Current Literature eulogo1

By: Francesco Porpiglialowast , Alessandro Volpe, Michele Billia and Roberto Mario Scarpa

European Urology, Volume 53 Issue 1, April 2008, Pages 732-743

Published online: 01 April 2008

Keywords: Laparoscopy, Partial nephrectomy, Renal cell carcinoma, Renal tumour

Abstract Full Text Full Text PDF (222 KB)

Abstract

Objectives

To critically review the current scientific evidence about open partial nephrectomy (OPN) and laparoscopic partial nephrectomy (LPN) to define the current role of these techniques in the treatment of renal tumours.

Methods

PubMed and Medline were searched for reports about OPN and LPN that were published from 1990 to 2007 and the most relevant papers were reviewed.

Results

OPN is an established curative approach for the treatment of small renal tumours. LPN is challenging and the technique is still under development. The intermediate-term oncologic and functional outcomes of LPN are similar to those of OPN in experienced centres. However, the ischaemia time is longer in laparoscopy and a long learning curve is needed to decrease the risk of complications. In the first phase of a surgeon's experience with LPN, a careful case selection based on the tumour growth pattern is required.

Conclusion

OPN is today the first treatment option for small renal tumours. LPN is technically challenging, but has been shown to achieve similar intermediate-term cancer cure and renal function results in centres with advanced laparoscopic expertise. Larger series with longer follow-up and prospective randomised studies are needed to confirm the safety and efficacy of LPN.

Take Home Message

Open partial nephrectomy is an established treatment option for small renal tumours. Laparoscopic partial nephrectomy can achieve similar results in centres with advanced laparoscopic expertise, but a careful patient selection is needed in the first part of the learning curve.

Keywords: Laparoscopy, Partial nephrectomy, Renal cell carcinoma, Renal tumour.

Footnotes

Department of Urology, San Luigi Hospital, Orbassano, University of Turin, Turin, Italy

lowast Corresponding author. Department of Urology, San Luigi Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Torino, Italy. Tel. +390119026558; Fax: +390119026244.

z.star Please visit www.eu-acme.org/europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically.

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