Effect of retroperitoneal laparoscopic partial nephrectomywith nephron-sparing surgery for T₁ stage renal tumors

  Objective  To investigate the clinical efficacy of retroperitoneal laparoscopic partial nephrectomy with nephron-sparing surgery for T₁ stage renal tumor and its effect on renal function and quality of life.

  Methods  A total of 100 patients with T₁ stage renal tumor admitted to our hospital were randomly divided into control group and observation group, receiving open partial nephrectomy, retroperitoneal laparoscopic partial nephrectomy with nephron-sparing surgery, respectively. Postoperative clinical efficacy, surgical related conditions, liver and kidney functions, quality of life scores, postoperative complications and recurrence rates of the two groups were compared.

  Results  At 1 week after the operation, the total effective rate of the observation group was significantly better than that in the control group(P < 0.05). The operative time, intraoperative blood loss, postoperative hospital stay and postoperative blood loss as well as time of renal pedicle vessel occlusion in the observation group were significantly better than those in the control group (P < 0.05). Intraoperative blood transfusion rate in two groups showed no significant difference(P>0.05). Liver and kidney functions of the two groups were reduced after surgery, and blood urea nitrogen (BUN), serum creatinine (Scr), uric acid (UA), endogenous creatinine clearance (Ccr), glomerular filtration rate (GFR) changed more significantly in the observation group than those in the control group (P < 0.05). The scores of survival quality at 1, 3 and 6 months after surgery of the observation group were significantly higher than that of the control group (P < 0.05). The survival rates of the observation group were higher than that of the control group after follow-up for 1, 2 and 3 years, showing no significant difference (P>0.05); the incidences of complications such as urine leakage, hematoma, incision infection and bleeding as well as recurrence rate in the observation group were significantly lower than that in the control group, but no significant differences were found in two groups(P>0.05).

  Conclusion  Compared with traditional open partial nephrectomy, retroperitoneal laparoscopic partial nephrectomy with nephron-sparing surgery has advantages in clinical efficacy, surgical conditions, liver and kidney function, quality of life and complications.