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Article
Laparoscopic Partial Nephrectomy for Hilar Tumors: Oncologic and Renal Functional Outcomes
Urology
  • A. K. George, Northwell Health
  • A. S. Herati
  • S. Rais-Bahrami
  • N. Waingankar
  • L. R. Kavoussi, Hofstra Northwell School of Medicine
Publication Date
2014
Abstract
OBJECTIVE To present our experience with laparoscopic partial nephrectomy (LPN) for hilar tumors and evaluate intermediate oncologic and renal functional outcomes. MATERIALS AND METHODS A retrospective review of LPN cases performed in 488 patients was performed. Hilar lesions were defined as renal cortical tumors in direct physical contact with the renal artery, vein, or both, as identified on preoperative imaging and confirmed intraoperatively. The clinicopathologic parameters, perioperative course, complications, and oncologic and 6-month renal functional outcomes were analyzed. RESULTS A total of 488 patients underwent LPN, of which 43 were hilar. The mean tumor size for hilar and nonhilar tumors was 3.6 cm and 3.1 cm, respectively. The mean operative time was shorter for hilar as compared with nonhilar tumors (129.1 minutes vs 141.8 minutes). Mean estimated blood loss was greater in LPN for hilar tumors (311.65 mL vs 298.4 mL). There were no statistically significant differences noted in any of the perioperative parameters investigated despite a higher nephrometry complexity score in the hilar group. Change in estimated glomerular filtration rate at 6 months showed a decrease of 10.9 mL/min and 8.8 mL/min for hilar and nonhilar tumors, respectively (P = NS). There was 1 recurrence detected in the hilar group, with a median follow-up of 41.6 months. CONCLUSION In the hands of an experienced laparoscopist, LPN can safely be performed for hilar tumors, with preservation of perioperative outcomes and durable renal functional and oncologic outcomes. (C) 2014 Elsevier Inc.
Pages
111-115
Document Type
Article
EPub Date
2013/10/15
Status
Faculty; Northwell Researcher
Facility
School of Medicine; Northwell Health
Primary Department
Urology
PMID

24119677

DOI
10.1016/j.urology.2013.08.059
Disciplines
Citation Information
A. K. George, A. S. Herati, S. Rais-Bahrami, N. Waingankar, et al.. "Laparoscopic Partial Nephrectomy for Hilar Tumors: Oncologic and Renal Functional Outcomes" Urology Vol. 83 Iss. 1 (2014)
Available at: http://works.bepress.com/louis-kavoussi/9/