Laparoscopic radical nephrectomy for renal masses 7 centimeters or larger

James S. Rosoff, Jay D. Raman, R. Ernest Sosa, Joseph J. Del Pizzo

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Objective: To report our operative experience and oncologic outcomes for the laparoscopic management of large renal tumors. Methods: All laparoscopic and hand-assisted laparoscopic radical nephrectomies performed at our institution were reviewed. Thirty patients with tumors ≥7cm and a pathologic diagnosis of renal cell carcinoma were included. Results: Mean operative time was 175.7±24.5 minutes, and mean estimated blood loss was 275.5±165.8 mL. No case required conversion to open radical nephrectomy. The mean hospital stay was 2.4±1.6 days. Four patients (13%) had minor complications. Of the 30 tumors, 18 were pathologic stage T2, 9 were stage T3a, 2 were stage T3b, and one was stage T4. At a mean follow-up of 30 months(range, 10 to 70), 22 patients (73%) were alive without evidence of recurrence, and 5 patients (17%) were alive with disease. One patient (3%) died of complications related to renal cell carcinoma, and 2 patients (7%) died from other causes. Overall survival was 90%, cancer-specific survival was 97%, and recurrence-free survival was 80%. Conclusion: Laparoscopic radical nephrectomy for large tumors is a technically challenging operation. However, in experienced hands, it is a reasonable therapeutic option for the management of larger RCC neoplasms.

Original languageEnglish (US)
Pages (from-to)148-153
Number of pages6
JournalJournal of the Society of Laparoendoscopic Surgeons
Volume13
Issue number2
StatePublished - Nov 2 2009

All Science Journal Classification (ASJC) codes

  • Surgery

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