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Organo Oficial de la Sociedad Mexicana de Urología

2020, Number 1

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Rev Mex Urol 2020; 80 (1)

Laparoscopic vs. open approach for the surgical treatment of renal tumors: Experience at the Centro Médico ISSEMyM Toluca, Mexico

Rosales-Velázquez CE, Gallegos-Sánchez G, Montaño-Roca BE, Ruvalcaba-Oceguera GE

Language: Spanish
References: 25
Page: 1-14
PDF size: 689.34 Kb.


ABSTRACT

Objective: Describe the experience in the conventional and laparoscopic surgical treatment of renal tumors in our medical center
Methodology: Retrospective and descriptive study. The database of patients with renal tumors treated by laparoscopic and open radical nephrectomy between January 2013 and April 2019 was analyzed and clinical, biochemical and histopathological variables and follow-up time were analyzed
Results: 50 laparoscopic and 44 open nephrectomies were performed. In general, the median age was 60 years, the male sex and the right kidney were the most operated (58.5% and 57.4%), the average tumor size was smaller for the laparoscopic approach than for the open one (5.1cm vs 6cm) , in both procedures the most frequent clinical stage was I and pT1 staging represented 60.6%, the average bleeding and the days of hospital stay were lower for the laparoscopic procedure than for the open procedure (372ml vs. 419ml and 1.9 vs. 3.7 days) and the surgical time was longer in laparoscopic nephrectomy than in open (164 vs. 133 minutes).
Conclusions: Radical surgical treatment for renal tumors remains the gold standard. As options for this treatment, there is the laparoscopic and conventional procedure, obtaining similar oncological results.


REFERENCES

  1. Allen BC, Remer EM. Percutaneous Cryoablation of Renal Tumors: Patient Selection, Technique, and Postprocedural Imaging. RadioGraphics. 2010 Jul 1;30(4):887–900. doi: https://doi. org/10.1148/rg.304095134

  2. Mennitto A, Verzoni E, Grassi P, Ratta R, Fucà G, Procopio G. Multimodal treatment of advanced renal cancer in 2017. Expert Review of Clinical Pharmacology. 2017 Dec 2;10(12):1395–402. doi: https://doi.org/10.10 80/17512433.2017.1386552

  3. Williams SK, de la Rosette JJMCH, Landman J, Keeley FX. Cryoablation of Small Renal Tumors. EAU-EBU Update Series. 2007 Oct 1;5(5):206–18. doi: https://doi.org/10.1016/j. eeus.2007.05.001

  4. Kavoussi N, Canvasser N, Caddedu J. Ablative Therapies for the Treatment of Small Renal Masses: a Review of Different Modalities and Outcomes. Curr Urol Rep. 2016 Jun 25;17(8):59. doi: https://doi.org/10.1007/s11934-016- 0611-5

  5. Zondervan PJ, Buijs M, de la Rosette JJ, van Delden O, van Lienden K, Laguna MP. Cryoablation of small kidney tumors. International Journal of Surgery. 2016 Dec 1;36:533–40. doi: https://doi.org/10.1016/j. ijsu.2016.06.049

  6. Pessoa RR, Autorino R, Laguna MP, Molina WR, Gustafson D, Nogueira L, et al. Laparoscopic Versus Percutaneous Cryoablation of Small Renal Mass: Systematic Review and Cumulative Analysis of Comparative Studies. Clinical Genitourinary Cancer. 2017 Oct 1;15(5):513- 519.e5. doi: https://doi.org/10.1016/j. clgc.2017.02.003

  7. Kurt SA, Yücel C, Oktar SÖ, Erbaş G, Sözen TS, Öner AY. The effectiveness of RENAL nephrometry score in ablated renal tumors via radiofrequency ablation or cryoablation. Turk J Med Sci. 2019 Jun 18;49(3):761–8. doi: http:// dx.doi.org/10.3906/sag-1811-131http:// dx.doi.org/10.3906/sag-1811-131

  8. Uhlig J, Strauss A, Rücker G, Seif Amir Hosseini A, Lotz J, Trojan L, et al. Partial nephrectomy versus ablative techniques for small renal masses: a systematic review and network meta-analysis. Eur Radiol. 2019 Mar 1;29(3):1293–307. doi: https://doi.org/10.1007/s00330-018-5660-3

  9. Iannuccilli JD, Dupuy DE, Beland MD, Machan JT, Golijanin DJ, Mayo-Smith WW. Effectiveness and safety of computed tomography-guided radiofrequency ablation of renal cancer: a 14-year single institution experience in 203 patients. Eur Radiol. 2016 Jun 1;26(6):1656–64. doi: https://doi.org/10.1007/ s00330-015-4006-7

  10. Gupta M, Alam R, Patel HD, Semerjian A, Gorin MA, Johnson MH, et al. Use of delayed intervention for small renal masses initially managed with active surveillance. Urologic Oncology: Seminars and Original Investigations. 2019 Jan 1;37(1):18–25. doi: https://doi. org/10.1016/j.urolonc.2018.10.001

  11. Ochoa Gutiérrez HE, Serrano Brambila EA, Moreno Palacios J, Montoya Martínez G. Comparación entre nefrectomía laparoscópica vs. abierta en el Hospital de Especialidades CMN Siglo XXI. Boletín del Colegio Mexicano de Urología. 2013;38(3):115–21.

  12. Arriaga Morales HR, Gutiérrez Godínez F. Complicaciones de las cirugías renales por cáncer en el Hospital General de México. Rev Mex Urol. 2005;65(3):157–65.

  13. Campos-Salcedo JG, Bravo-Castro EI, Sedano- Lozano A, Torres-Salazar JJ, Hernández- Martínez G, Estrada-Carrasco CE, et al. Experiencia de nefrectomía laparoscópica en el Hospital Central Militar. Rev Mex Urol. 2013 Mar 1;73(2):72–6.

  14. Rivera-Ramírez JA, Cendejas-Gómez JJ, Gabilondo-Pliego B, Rodríguez-Covarrubias F. Abordaje laparoscópico para el tratamiento quirúrgico de los tumores renales y del tracto urinario superior. Revista Mexicana de Urología. 2016 Sep;76(5):279–83. doi: https://dx.doi. org/10.1016/j.uromx.2016.06.002

  15. Solís Rodríguez JA, García Vásquez RA, Arriaga Aguilar J, Candia Plata M del C, Chavarría Guevara J. Nefrectomía radical. Comparación de resultados por técnica laparoscópica y abierta en el Hospital General del Estado de Sonora. Colegio Mexicano de Urología Nacional, AC. 2015;24.

  16. Becker A, Pradel L, Kluth L, Schmid M, Eichelberg C, Ahyai S, et al. Laparoscopic versus open partial nephrectomy for clinical T1 renal masses: no impact of surgical approach on perioperative complications and long-term postoperative quality of life. World J Urol. 2015 Mar 1;33(3):421–6. doi: https://doi. org/10.1007/s00345-014-1318-1

  17. Xu H, Ding Q, Jiang H. Fewer complications after laparoscopic nephrectomy as compared to the open procedure with the modified Clavien classification system--a retrospective analysis from southern China. World J Surg Oncol. 2014 Jul 31;12:242. doi: https://doi. org/10.1186/1477-7819-12-242

  18. Yang C, Wang Z, Huang S, Xue L, Fu D, Chong T. Retroperitoneal Laparoscopic Partial Nephrectomy Versus Radical Nephrectomy for Clinical T1 Renal Hilar Tumor: Comparison of Perioperative Characteristics and Short-Term Functional and Oncologic Outcomes. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2018 Apr 18;28(10):1183–7. doi: https://doi.org/10.1089/lap.2018.0064

  19. Banegas MP, Harlan LC, Mann B, Yabroff KR. Toward greater adoption of minimally invasive and nephron-sparing surgical techniques for renal cell cancer in the United States. Urologic Oncology: Seminars and Original Investigations. 2016 Oct 1;34(10):433.e9-433.e17. doi: https:// doi.org/10.1016/j.urolonc.2016.05.021

  20. Johnson BA, Cadeddu JA. Current opinion in urology 2017: focal therapy of small renal lesions. Current Opinion in Urology. 2018 Mar;28(2):166–171. doi: https://doi. org/10.1097/MOU.0000000000000475

  21. Solares E, Martínez F, Jiménez-Rios MÁ. Nefrectomía radical laparoscópica en el Instituto Nacional de Cancerología. Rev Mex Urol. 2011;71(6):338–44.

  22. Pineda-Sotomayor RE, Reyes-García IA, Aragón-Tovar AR, Palacios-Saucedo GC. Nefrectomía abierta vs. laparoscópica, experiencia en un hospital de tercer nivel en el noreste de México. Revista Mexicana de Urología. 2014 Jul 1;74(4):208–10. doi: https:// doi.org/10.1016/S2007-4085(15)30042-2

  23. Becker A, Ravi P, Roghmann F, Trinh Q-D, Tian Z, Larouche A, et al. Laparoscopic Radical Nephrectomy vs Laparoscopic or Open Partial Nephrectomy for T1 Renal Cell Carcinoma: Comparison of Complication Rates in Elderly Patients During the Initial Phase of Adoption. Urology. 2014 Jun 1;83(6):1285–93. doi: https://doi.org/10.1016/j.urology.2014.01.050

  24. Sagalovich D, Dagenais J, Bertolo R, Garisto JD, Kaouk JH. Trifecta Outcomes in Renal Hilar Tumors: A Comparison Between Robotic and Open Partial Nephrectomy. Journal of Endourology. 2018 Jul 9;32(9):831–6. doi: https://doi.org/10.1089/end.2018.0445

  25. Minervini A, Siena G, Antonelli A, Bianchi G, Bocciardi AM, Cosciani Cunico S, et al. Open versus laparoscopic partial nephrectomy for clinical T1a renal masses: a matched-pair comparison of 280 patients with TRIFECTA outcomes (RECORd Project). World J Urol. 2014 Feb 1;32(1):257–63. doi: https://doi. org/10.1007/s00345-013-1155-7




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