3D laparoscopic enucleation vs standard partial nephrectomy for cT1 renal masses: assessment of functional outcomes at 1-year follow-up

Abstract

AIM: To evaluate renal function after laparoscopic nephron-sparing surgery (NSS) and to establish the factors that might influence its dynamic one year after surgery.

METHODS: The prospective study included 83 patients previously diagnosed with renal cell carcinoma who underwent laparoscopic NSS. Demographic, clinical, laboratory and surgery related data were recorded. Patients were followed up for one year after surgery.

RESULTS: The majority of cases (63 (76.8%)) were included in stage T1a. Almost two thirds of patients underwent partial nephrectomy (PN) (54 (65.1%)). A slight decrease in GFR was observed 1 year after surgery (80.1±21.5 ml/min; 75.3±22.4 ml/min respectively) in all patients. Univariate analysis showed a significant decrease in GFR values one year after surgery for patients who underwent standard PN as compared with those from the enucleation group (p=0.003). Male patients showed a significant decrease in GFR one year after surgery, as compared with female patients (p<0.001), and elderly patients were more likely to show lower GFR. When considering the simultaneous influence of age, gender and type of surgery on the evolution of GFR, the threshold for statistical significance was slightly crossed (p=0.2).

CONCLUSION: Partial nephrectomy as compared to enucleation, advanced age and male gender are associated with impaired renal function at one year after laparoscopic NSS.