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A prospective evaluation of 3-D laparoscopic transperitoneal radical nephrectomy for large renal tumors (clinical stage T2N0M0): A single-centre, single-surgeon experience
Anup Kumar, Niraj Kumar, Gaurav Kumar, Mikir Patel, Pankaj Gupta
Department of Urology & Renal Transplant,VMMC & Safdarjung Hospital, New Delhi, India
Citation: Kumar A, Kumar N, Kumar G, Patel M, Gupta P A prospective evaluation of 3-D laparoscopic transperitoneal radical nephrectomy for large renal tumors (clinical stage T2N0M0): A single-centre, single-surgeon experience. www.ceju.online/journal/10000/renal-tumor-TNM-laparoscopic-nephrectomy-1506.php
Key Words: laparoscopic nephrectomy • renal tumor • T2N0M0

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

Introduction and Objectives: To prospectively evaluate the feasibility, safety and long-term results of 3-D laparoscopic transperitoneal radical nephrectomy(LRN) large renal tumors(clinical T2N0M0).

Materials and Methods: 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.

Results: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 was required. The blood transfusion was required in 5(9.8%) patients. The mean hospital stays and mean convalescence period were 3.5 days and 1.49 weeks respectively. The intraoperative and postoperative complications were seen in 3(5.8% - bleeding:1,bowel injury:1) and 5(7.8% - wound infection :1,delayed bleeding:1,atelectasis:1,ileus:1) respectively. The 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 were 92.3%,94.1% and 96.1% respectively.

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

ACKNOWLEDGMENTS:  none
Article history
Submitted: 3 July, 2017
Accepted: 18 August, 2017
Published online: 7 September, 2017
doi: 10.5173/ceju.2017.1506
Corresponding author
Gaurav Kumar
email: drgauravkumar02@gmail.com
Conflicts of interest:  The authors declare no conflicts of interest.
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