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The improvements in laparoscopic urological surgery have made laparoscopic adenomectomy (LA) possible in voluminous prostatic adenomas.The objective of this study was to assess the results of the LA and compared them with results of the open adenomectomy (OA).A comparative study of 41 patients undergoing LA [23 LA with Millin technique (LA-MT) and 21 with transvesical technique (LA-TV)] was conducted with 44 patients undergoing OL in prostate adenomas100 grams. Data were recorded prospectively, at three different institutions. Preoperative, intraoperative, postoperative and complications results were evaluated.Prostate volume was 165 (100-345) gr for LA versus 170 (100-328) gr for OA (p=0.669). Preoperative IPSS was 3 (0-3) and Q max. 7 (0-15) for LA against 2 (0-3) and 7 (0-15.3) for OA (p=0.296;p=0.316). There was no difference in surgical time (p=0.069) between both techniques. LA had less operative bleeding, 100 (10-1000) ml than OA, 500 (100-1000) ml (p=0.0001) and a shorter hospital stay, 3 (1-8) days against 3.5 (3-10) days (p=0.0001), postoperative IPSS was 1 (1-2) and Q max. 25 (17-45) for LA against 1 (1-3) and 25.5 (12-44) for OA (p=0889;p=836). There were no differences neither in transfusions requirements' nor complications.LA presented similar short-term functional results with less operative bleeding and shorter hospitalization time than OA with similar prostate volumes resected.INTRODUCCIÓN: Los avances en la cirugía laparoscópica urológica han permitido la realización de la adenomectomía simple laparoscópica (ASL) en adenomas prostáticos voluminosos.El objetivo de este estudio fue evaluar los resultados de la ASL y compararlos con la adenomectomía simple abierta (ASA).Se realizó un estudio comparativo de 41 pacientes sometidos a ASL [23 ASL con técnica de Millin (ASL-TM) y 21 con técnica transvesical (ASL-TV)] con 44 pacientes sometidos a ASA en adenomasde próstata100 gramos. Los datos se registraron de modo prospectivo, en tres centros diferentes. Se evaluaron los resultados preoperatorios, operatorios, postoperatorios y complicaciones según escala de Clavien.El volumen prostático fue 165 (100-345) gr para ASL contra 170 (100-328) gr para ASA (p=0,669). IPSS preoperatorio 3 (0-3) y Q máx. 7 (0-15) para ASL contra 2 (0-3) y 7 (0-15,3) para ASA (p=0,296; p=0,316). No hubo diferencia tiempo quirúrgico (p=0,069). ASL tuvo menos sangrado operatorio100 (10-1000) ml que la ASA 500 (100-1000) ml (p=0,0001) y una menor estadía hospitalaria 3 (1-8) días contra 3,5 (3-10) días (p=0,0001), IPSS postoperatorio1 (1-2) y Q máx. 25 (17-45) para ASL contra 1(1-3) y 25,5 (12-44) para ASA (p=0889; p=836). No hubo diferencias en el requerimiento de transfusiones ni complicaciones.CONCLUSIÓN: La ASL presentó similares resultados funcionales a corto plazo con un menor sangrado operatorio y tiempo de hospitalización que la ASA y una baja tasa de complicaciones a similares volúmenes prostáticos resecados.

The aim of this paper is to describe the epidemiological characteristics, clinical management and pathologic patterns in a population with renal tumors in our institution. Prospective data collection was performed over a period of 4.5 years, from January 2010 to June 2014. A total of 819 cases (796 patients) were treated for renal mass during this period. The mean age was 60.7 years (SD 13.1). There were 553 (69.5%) males (male to female ratio: 2.2: 1). Twenty nine per cent (230 patients) were obese (BMI = 30). The diagnosis was incidental in 653 cases (79.7%), 48.8% presented one or more risk factors, being smoking the most frequent (34%). In 238 patients (29.9%) there was more than one comorbidity; 18% had preoperative creatinine = 1.3 mg/dl. Lesions were = 4 cm (cT1a) in 45% of the patients, and 10.8% (86) had metastases at diagnosis. The lesions were resected in 93.5% and actively monitored in 6.5% (not resected). In surgery treated patients, radical nephrectomy was performed in 51.5% of cases, and nephron sparing surgery in 48.5% of them. The laparoscopic approach was used in 56.2%. The pattern of presentation of renal masses is characterized by incidental diagnosis in early disease stages. Nephron sparing surgery is the first choice in nearly half of patients. Active surveillance has been used in a greater percentage than previously reported.