A prospective evaluation of 3-D laparoscopic transperitoneal radical nephrectomy for large renal tumors (clinical stage T2N0M0): A single-centre, single-surgeon experience

The aim of this study is to prospectively evaluate the feasibility, safety and long-term results of 3-D laparoscopic transperitoneal radical nephrectomy (LRN) of large renal tumors (clinical stage T2N0M0).

All consecutive patients undergoing 3-D laparoscopic radical nephrectomy (LRN) for a clinical stage T2N0M0 by a single surgeon between January 2011 and March 2016 at our institution were included. The various clinical data including patient's demographic profile, intraoperative and postoperative data, complications and follow-up were recorded and analyzed.

A total of 51 patients were included in the study. The mean tumor size was 7.9 cm. Limited hilar lymphadenectomy was performed in 38 (74.5%) patients. Concomitant lymphadenectomy was performed in 15 (29.4%) patients. The mean operating time and mean estimated blood loss were 179.3 min and 193.1 ml respectively. In 3 (5.8%) patients, conversion to open surgery was required. Blood transfusions were required in 5 (9.8%) patients. The mean hospital stay and mean convalescence period were 3.5 days and 1.49 weeks respectively. Intraoperative (5.8% – bleeding: 1, bowel injury: 1) and postoperative complications (7.8% – wound infection: 1, delayed bleeding: 1, atelectasis: 1, ileus: 1) were seen in 3 and 5 patients respectively. Renal cell carcinoma and oncocytoma were found on histopathological examination in 48 (94.1%) and 3 (5.9%) patients respectively. At the mean follow-up of 49.1 months, there were 2 distant metastases (brain – 1, lung – 1).The 5-year overall, cancer-specific and recurrence-free survival rates were 92.3%, 94.1% and 96.1% respectively.

The 3-D LRN for large renal tumors (clinical stage T2N0M0) is technically feasible, safe, and effective with good long-term survival outcomes. However, this technically challenging procedure should be attempted by surgeons of significant expertise.

CONFLICTS OF INTEREST

The authors declare no conflicts of interest.

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