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Assessment of surgical margins in renal cell carcinoma after nephron sparing: a comparative study: laparoscopy vs open surgery.
- Source :
-
The Journal of urology [J Urol] 2005 Apr; Vol. 173 (4), pp. 1098-101. - Publication Year :
- 2005
-
Abstract
- Purpose: We compared the status of the peritumoral parenchyma after open and laparoscopic nephron sparing surgery for renal cell carcinoma.<br />Materials and Methods: The records of 64 consecutive patients who underwent nephron sparing surgery for renal cell carcinoma of 4 cm or less were reviewed retrospectively. Patients in group 1 underwent open retroperitoneal surgery (1998 to 2000) and patients in group 2 underwent laparoscopic (transperitoneal or retro peritoneal) surgery (2001 to March 2004). A single pathologist was employed to analyze the specimens, and comparative analysis included examination of tumor size, weight, histological cell type, intraoperative histological biopsies and margin status.<br />Results: The 2 groups were comparable in terms of clinical data, and mean lesion size was 31.4 mm in group 1 and 32 mm in group 2. Positive margins were found in 1 of 30 patients in group 1 and in 1 of 34 in group 2 (p = 0.9). An analysis of margins was performed by taking measurements at the minimum and maximum points of the section. The minimum mean measurement was 2 mm in group 1 and 2.08 mm in group 2 (p = 0.75). The maximum mean measurement was 4.56 mm in group 1 and 5.2 mm in group 2 (p = 0.09). The difference between minimum and maximum margin thickness was 2.56 mm in group 1 and 3.16 mm in group 2 (p = 0.04). Mean followup for group 1 was 50 months (range 30 to 72) and 16 months (range 2 to 35) for group 2. One local recurrence was recorded in group 1 and treated with radical nephrectomy, while no recurrence was recorded in group 2.<br />Conclusions: In this study we further confirmed the efficiency of resectioning lesions using laparoscopy. In our experience there is no difference between the 2 procedures in terms of efficient surgical margins. However, despite these encouraging results it is necessary to obtain more extensive followup data, which will allow us to be more specific in reporting on laparoscopic margin quality.
- Subjects :
- Adult
Aged
Aged, 80 and over
Biopsy
Carcinoma, Renal Cell surgery
Female
Follow-Up Studies
Frozen Sections
Humans
Intraoperative Care
Kidney Neoplasms surgery
Male
Middle Aged
Neoplasm Recurrence, Local pathology
Neoplasm Staging
Nephrons surgery
Retrospective Studies
Carcinoma, Renal Cell pathology
Kidney Neoplasms pathology
Laparoscopy methods
Nephrectomy methods
Nephrons pathology
Subjects
Details
- Language :
- English
- ISSN :
- 0022-5347
- Volume :
- 173
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Journal of urology
- Publication Type :
- Academic Journal
- Accession number :
- 15758709
- Full Text :
- https://doi.org/10.1097/01.ju.0000148360.47191.5e