Laparoscopic versus Open Partial Nephrectomy for Multilocular Cystic Renal Cell Carcinoma: A Direct Comparison Based on Single-Center Experience

Abstract

Objectives: To compare the treatment of laparoscopic (LPN) versus open partial nephrectomy (OPN) in patients with multilocular cystic renal cell carcinoma (MCRCC). Methods: Thirty-seven patients diagnosed with MCRCC were reviewed retrospectively between January 2007 and January 2013 at our institution. They were divided into two groups: group 1 (LPN) consisted of 19 patients (51.4%) and group 2 (OPN) of 18 patients (48.6%). RENAL and the Preoperative Aspects and Dimensions Used for an Anatomical classification were applied to predict perioperative complications, which were graded based on the Clavien-Dindo classification. Results: The two groups were comparable with regard to all of the patients' baseline characteristics. In group 1, the mean operative time was 142.1 min, including the mean warm ischemia time (WIT) of 32.6 min; the mean estimated blood loss (EBL) was 96.1 ml, the mean retroperitoneal drainage lasted 3.6 days, and the mean postoperative hospital stay was 5.3 days. In group 2, the figures were 126.6 and 23.5 min, 223.3 ml, and 4.6 and 8.7 days, respectively. The differences in WIT, EBL, drainage days and hospitalization were statistically significant between both groups (p < 0.05). No recurrence or new lesions occurred in these patients during a mean follow-up of 37.8 months. Conclusions: Our single-center experience suggests that although it remains technically complex, demanding and challenging for MCRCC, LPN can still induce favorable perioperative results and survival rates in MCRCC are comparable with OPN.