Laparoscopic partial nephrectomy for large renal masses: results of a European survey

World J Urol. 2010 Aug;28(4):525-9. doi: 10.1007/s00345-010-0518-6. Epub 2010 Mar 4.


Objective: To evaluate the perioperative effectiveness of laparoscopic partial nephrectomy (LPN) for large (4-7 cm) renal masses, with a review of the experience of six European advanced laparoscopic centres.

Patients and methods: A survey was planned; data were extracted from each institutional data base to obtain information about patients who had undergone LPN for renal masses larger than 4 cm. Demographic, radiological growth patterns of the tumours and intraoperative data were collected. Post-operative complications and pathological data were also recorded. All data were processed through statistical software.

Results: Data on 63 patients were collected. Radiological tumour size was 4.7 cm (4.1-7), growth pattern was cortical in 33 cases and cortico-medullar in 30 cases. Warm ischemia time (WIT) was 25.7 min in 7.3% cases bleeding occurred intra-operatively, post-operative surgical complications occurred in 14.6% cases. Pathological analyses revealed malignant lesion in 73% and positive margins in 6.5%. Complications and positive margins are more frequent for cortico-medullar lesions.

Conclusions: This survey confirms that LPN for tumours 4-7 cm in size is feasible in experienced hands. WIT and overall complication rate remain questionable points.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Europe / epidemiology
  • Female
  • Health Care Surveys*
  • Humans
  • Ischemia / epidemiology
  • Ischemia / prevention & control
  • Kidney Neoplasms / epidemiology*
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery*
  • Laparoscopy / statistics & numerical data*
  • Male
  • Middle Aged
  • Morbidity
  • Nephrectomy / methods
  • Nephrectomy / statistics & numerical data*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Retrospective Studies