Minimally invasive partial nephrectomy for single versus multiple renal tumors

Andre Luis De Castro Abreu, Andre K. Berger, Monish Aron, Osamu Ukimura, Robert J. Stein, Inderbir S. Gill, Mihir M. Desai

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Purpose: We report the perioperative outcomes of robotic/laparoscopic partial nephrectomy for multiple tumors at a single operative session. Outcomes were compared with those of a matched pair cohort treated with partial nephrectomy for a single renal tumor. Materials and Methods: We retrospectively reviewed a prospectively maintained database from 2001 to 2010 and identified 33 patients who underwent partial nephrectomy for multiple tumors. They were matched 1 to 1 with 33 patients treated with partial nephrectomy for a single tumor. The multiple and single groups were matched for dominant tumor size (3.2 and 3.3 cm, p = 0.61), patient age (60 and 57 years, p = 0.59) and baseline estimated glomerular filtration rate (79.7 and 91.8 ml per minute/1.73 m 2, p = 0.11), respectively. Results: A total 114 tumors were excised, including 81 in the multiple cohort. There was a median of 2 tumors per kidney (range 2 to 6). In the multiple and single tumor groups estimated blood loss (250 and 235 ml, p = 0.46) and warm ischemia time (19 and 30 minutes, respectively, p = 0.18) were similar. Median operative time (300 vs 217 minutes, p = 0.002) and hospital stay (3 vs 1 days, p = 0.005) were longer in the multiple group. There were 2 conversions to laparoscopic radical nephrectomy per group. Overall, complications developed in 11 (33%) vs 7 patients (21%) treated with partial nephrectomy for multiple vs single tumors (p = 0.40). Median estimated glomerular filtration rate at discharge home was 62.8 vs 67.6 ml per minute/1.73 m2 in the multiple vs single tumor groups (p = 0.53). Histology confirmed malignancy in 82% and 67% of patients, respectively (p = 0.26). One recurrent tumor in the multiple group had a focal positive margin. Conclusions: Robotic/laparoscopic partial nephrectomy can be safely performed for multiple ipsilateral tumors with perioperative outcomes similar to those in patients with a solitary tumor.

Original languageEnglish (US)
Pages (from-to)462-467
Number of pages6
JournalJournal of Urology
Volume189
Issue number2
DOIs
StatePublished - Feb 1 2013

Keywords

  • kidney
  • kidney neoplasms
  • laparoscopy
  • nephrectomy
  • robotics

ASJC Scopus subject areas

  • Urology

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  • Cite this

    Abreu, A. L. D. C., Berger, A. K., Aron, M., Ukimura, O., Stein, R. J., Gill, I. S., & Desai, M. M. (2013). Minimally invasive partial nephrectomy for single versus multiple renal tumors. Journal of Urology, 189(2), 462-467. https://doi.org/10.1016/j.juro.2012.09.039