11. Results of retroperitoneal laparoscopic partial nephrectomy in the treatment of renal cell carcinoma
Main Article Content
Abstract
Renal cell carcinoma (RCC) is the most common type of kidney cancer, increasingly diagnosed at earlier stages credited to advances in imaging techniques. Retroperitoneal laparoscopic partial nephrectomy (RLPN) is a recommended treatment for early-stage RCC, aiming to preserve renal parenchyma while achieving oncologic outcomes comparable to radical nephrectomy. Objective: To evaluate the outcomes of RLPN in patients with localized RCC, including postoperative renal function, complications, and survival rates. Subjects and Methods: A cross-sectional descriptive study was conducted on 45 patients with localized RCC who underwent RLPN at the Department of Urology, Hanoi Medical University Hospital. Clinical characteristics, surgical outcomes, renal function, and survival data were analyzed. Results: The mean patient age was 54.6 ± 13.2 years old. The average operative time was 113.5 ± 34.7 minutes, mean warm ischemia time was 29.9 ± 9.9 minutes, and mean estimated blood loss was 147.6 ± 69.8mL. The complication rate was low, with no perioperative mortality or reoperations recorded. Postoperative renal function remained stable. Serum creatinine increased slightly and eGFR decreased with statistical significance, but both remained within physiological limits. At 5-years follow-up, overall survival (OS) was 81.9%. No case of recurrence observed during the follow-up period. Conclusion: RLPN is a safe and effective treatment option for early-stage RCC, demonstrating favorable survival outcomes, preserved renal function, and a low recurrence rate.
Article Details
Keywords
Renal cell carcinoma, laparoscopic surgery, partial nephrectomy, renal function, recurrence, overall survival
References
2. Ljungberg B, Albiges L, Abu-Ghanem Y, et al. European Association of Urology guidelines on renal cell carcinoma: the 2022 update. European urology. 2022;82(4):399-410.
3. Aron M, Turna B. Laparoscopic partial nephrectomy: Newer trends. Indian J Urol. Oct-Dec 2009;25(4):516-22. doi:10.4103/0970-1591.57931
4. Fu J, Ye S, Ye H-j. Retroperitoneal versus transperitoneal laparoscopic partial nephrectomy: A systematic review and meta-analysis. Chinese Medical Sciences Journal. 2015;30(4):239-244.
5. Almdalal T, Sundqvist P, Harmenberg U, et al. Clinical T1a Renal Cell Carcinoma, Not Always a Harmless Disease—A National Register Study. European Urology Open Science. 2022;39:22-28. doi:10.1016/j.euros.2022.03.005
6. Tian C, Liu J, Wang Y, et al. Prognostic outcomes of surgical modalities and predictive factors for distant metastases in T1a renal cell carcinoma: a SEER database analysis. Translational Andrology and Urology. 2025;14(3):669-677.
7. Cao Y, Cui Y, Li R, et al. Comparing the long-term prognosis and renal function changes of partial nephrectomy (PN) and radical nephrectomy (RN) in T1 stage renal cell carcinoma patients. Translational Andrology and Urology. 2025;14(3):740-750.
8. Khoo HC, Lim LY, Shukor S, et al. Initial experience of laparoscopic retroperitoneal partial nephrectomy in an academic hospital in Malaysia. Med J Malaysia. Nov 2022;77(6):764-767.
9. Ferakis N, Katsimantas A, Charalampogiannis N, et al. Transperitoneal and retroperitoneal approach in laparoscopic partial nephrectomy for posterior cT1 renal tumors: A retrospective, two-centers, comparative study. Archivio Italiano di Urologia e Andrologia. 2020;92(3)
10. Hoàng Long, Trần Quốc Hoà, Trần Trung Thành. Kết quả phẫu thuật nội soi cắt u bảo tồn thận tại Bệnh viện Đại học Y Hà Nội. Tạp chí Nghiên cứu Y học. 12/15 2023;171(10):265-271. doi:10.52852/tcncyh.v171i10.2048
11. Patel AR, Eggener SE. Warm ischemia less than 30 minutes is not necessarily safe during partial nephrectomy: every minute matters. Urol Oncol. Nov-Dec 2011;29(6):826-8. doi:10.1016/j.urolonc.2011.02.015
12. Do TT, Pham TD, Do MT, et al. Retroperitoneal laparoscopic partial nephrectomy with selective renal artery clamping for renal cell carcinoma: initial outcomes. Ann Med Surg (Lond). May 2024;86(5):2437-2441. doi:10.1097/ms9.0000000000001921
13. Pyo P, Chen A, Grasso M. Retroperitoneal laparoscopic partial nephrectomy: surgical experience and outcomes. J Urol. Oct 2008;180(4):1279-83. doi:10.1016/j.juro.2008.06.015
14. Keskin ET, Can O, Özdemir H, et al. Risk Factors of Open Surgery Conversion in Laparoscopic Partial Nephrectomy to Achieve Nephron Sparing. Ann Surg Oncol. Jun 2024;31(6):3880-3886. doi:10.1245/s10434-024-15106-1
15. Tang H, Shen T, Zhou K, et al. Retrospective comparison of clinical outcomes of robotic-assisted laparoscopic partial nephrectomy through transabdominal or retroperitoneal approaches in patients with T1b renal tumor. BMC Urol. Dec 21 2022;22(1):208. doi:10.1186/s12894-022-01162-w
16. Guo Y, Xu Q, Chen B, et al. Clinical outcomes and effect on intraoperative blood loss and postoperative pain of patients undergoing retroperitoneal laparoscopic partial nephrectomy for complex renal tumors. World J Surg Oncol. Sep 18 2021;19(1):282. doi:10.1186/s12957-021-02397-x
17. Alimu P, Dai J, Huang X, et al. Lateroconal fascia suspension facilitates retroperitoneal partial nephrectomy. Translational Cancer Research. 2022;11(5):1141-1145.
18. Hua M, Liu W, Wang C, et al. Trans-retro-peritoneal laparoscopic partial nephrectomy for posterior hilar tumor: technical feasibility and preliminary results. Transl Androl Urol. Nov 30 2023;12(11):1638-1644. doi:10.21037/tau-23-399
19. Nayan M, Saarela O, Lawson K, et al. Long-term outcomes after radical or partial nephrectomy for T1a renal cell carcinoma: A population-based study. Can Urol Assoc J. Dec 2020;14(12):392-397. doi:10.5489/cuaj.6343
20. Ren K, Wu F, Wu H, et al. Partial versus radical nephrectomy for T1b renal cell carcinoma: A comparison of efficacy and prognostic factors based on the Surveillance, Epidemiology, and End Results database. Curr Urol. Dec 2024;18(4):328-335. doi:10.1097/cu9.0000000000000229
21. Salkini MW, Idris N, Lamoshi AR. The incidence and pattern of renal cell carcinoma recurrence after robotic partial nephrectomy. Urol Ann. Oct-Dec 2019;11(4):353-357. doi:10.4103/ua.Ua_134_18
22. Kim J, Ham WS, Park JS, et al. Incidence and Pattern of Recurrence after Surgical Resection in Organ-Confined Renal Cell Carcinoma. Yonsei Med J. Nov 2024;65(11):623-628. doi:10.3349/ymj.2023.0587