Objective: To analyze feasibility and outcomes of laparoscopic partial nephrectomy (LPN) for endophytic hilar tumors in low-intermediate (ASA I-11) risk patients. Methods: This is a single centre retrospective study. From May 2009 to September 2011, 208 LPNs were performed at our institution. Overall 11 (5.2%) elective LPNs were for hilar tumors not visible on kidney surface. Hilar tumor was defined as a mass located in the renal hilum and in contact with a major renal vessel on preoperative imaging. Procedures were carried out by a single experienced surgeon (G.G.) via retroperitoneal approach by clamping the only main renal artery. Results: Mean (range) age of patients was 45.3 years (38.2-64.1), tumor size 1.6 cm (1.2-2.0), warm ischemia time 24 min (19-32), operative time 140 min (110-200) and estimated blood loss 270 ml (100-750). Two collecting system injuries were observed and repaired intraoperatively. No conversion to open surgery was required. Final pathological examination revealed 10 renal cell carcinomas and 1 Oncocytoma. A negative surgical margin was obtained in 10/11 (91%) patients. Renal function and serum hemoglobin were nearly unaltered pre and post-surgery. No tumor recurrence was observed at mean (range) follow-up of 34 months (15-43). Conclusions: In experienced hands, LPN represents a feasible, safe and effective treatment for selected patients diagnosed with endophytic hilar masses. A larger number of patients and longer follow-up are required to draw definitive conclusions. (c) 2013 Elsevier Ltd. All rights reserved.

Laparoscopic partial nephrectomy for endophytic hilar tumors: feasibility and outcomes / DI PIERRO, GIOVANNI BATTISTA; Tartaglia, Nicola; L., Aresu; A., Polara; A., Cielo; Cristini, Cristiano; Grande, Pietro; Gentile, Vincenzo; G., Grosso. - In: EUROPEAN JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0748-7983. - STAMPA. - 40:6(2014), pp. 769-774. [10.1016/j.ejso.2013.11.023]

Laparoscopic partial nephrectomy for endophytic hilar tumors: feasibility and outcomes

DI PIERRO, GIOVANNI BATTISTA;TARTAGLIA, NICOLA;CRISTINI, Cristiano;GRANDE, PIETRO;GENTILE, Vincenzo;
2014

Abstract

Objective: To analyze feasibility and outcomes of laparoscopic partial nephrectomy (LPN) for endophytic hilar tumors in low-intermediate (ASA I-11) risk patients. Methods: This is a single centre retrospective study. From May 2009 to September 2011, 208 LPNs were performed at our institution. Overall 11 (5.2%) elective LPNs were for hilar tumors not visible on kidney surface. Hilar tumor was defined as a mass located in the renal hilum and in contact with a major renal vessel on preoperative imaging. Procedures were carried out by a single experienced surgeon (G.G.) via retroperitoneal approach by clamping the only main renal artery. Results: Mean (range) age of patients was 45.3 years (38.2-64.1), tumor size 1.6 cm (1.2-2.0), warm ischemia time 24 min (19-32), operative time 140 min (110-200) and estimated blood loss 270 ml (100-750). Two collecting system injuries were observed and repaired intraoperatively. No conversion to open surgery was required. Final pathological examination revealed 10 renal cell carcinomas and 1 Oncocytoma. A negative surgical margin was obtained in 10/11 (91%) patients. Renal function and serum hemoglobin were nearly unaltered pre and post-surgery. No tumor recurrence was observed at mean (range) follow-up of 34 months (15-43). Conclusions: In experienced hands, LPN represents a feasible, safe and effective treatment for selected patients diagnosed with endophytic hilar masses. A larger number of patients and longer follow-up are required to draw definitive conclusions. (c) 2013 Elsevier Ltd. All rights reserved.
2014
laparoscopic partial nephrectomy; complications; renal function; tumor recurrence; endophytic hilar tumors
01 Pubblicazione su rivista::01a Articolo in rivista
Laparoscopic partial nephrectomy for endophytic hilar tumors: feasibility and outcomes / DI PIERRO, GIOVANNI BATTISTA; Tartaglia, Nicola; L., Aresu; A., Polara; A., Cielo; Cristini, Cristiano; Grande, Pietro; Gentile, Vincenzo; G., Grosso. - In: EUROPEAN JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0748-7983. - STAMPA. - 40:6(2014), pp. 769-774. [10.1016/j.ejso.2013.11.023]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/535325
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