Clinical experience with laparoscopic radical nephrectomy for renal cell carcinoma.

Objectives: We performed a comparative study of laparoscopic radical nephrectomy (LRN) and open radical nephrectomy (ORN) for renal cell carcinoma, and a comparative study of transperitoneal (LRN-TP) versus retroperitoneal LRN (LRN-RP) for renal cell carcinoma.

Materials And Methods: A total of 100 patients underwent radical nephrectomy for stage T1 and T2 disease. Of the 100 cases, 34 (34.0%) were treated with LRN-TP, 33 (33.0%) with LRN-RP, and 33 (33.0%) with ORN. Each group was reviewed with respect to complications, postoperative convalescence, and the relationship between body mass index and operative time.

Results: Mean operative times of LRN-TP, LRN-RP and ORN were 305.7, 296.2, and 218.1 min, and mean blood losses were 236.3, 101.7, and 690.5 ml, respectively. Body mass index and mean operative time exhibited equilateral correlation in the three groups. In one case (1.5%) of LRN (67 cases), conversion to open surgery was necessary due to bleeding, and LRN-TP was performed. In one case (1.5%), intraoperative complications occurred but could be managed laparoscopically. Three cases (9.1%) of ORN required blood transfusion.

Conclusions: LRN results in less blood loss, less postoperative pain, quicker oral intake, shorter hospitalization, and a more rapid recovery than ORN, although LRN requires longer operative time than ORN.