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Published in: Current Urology Reports 1/2013

01-02-2013 | Kidney Diseases (G Ciancio, Section Editor)

Partial Nephrectomy: Is There Still a Need for Open Surgery?

Authors: Varun Sharma, Markus Margreiter

Published in: Current Urology Reports | Issue 1/2013

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Abstract

Long-term outcome data indicate that open partial nephrectomy has cancer-free survival rates comparable to those of radical surgery, with better preservation of renal function, decreased overall mortality and reduced frequency of cardiovascular events. Open partial nephrectomy is increasingly being challenged by laparoscopic and/or robot assisted partial nephrectomy, which in the hands of experts appears to achieve comparable oncological results, albeit at a higher complication rate. We report a review based on literature published over the past years, which may provide insight into the role of open partial nephrectomy in the present urological practice and in years to come.
Literature
1.
go back to reference Ljungberg B, Cowan NC, Hanbury DC, Hora M, Kuczyk MA, Merseburger AS, et al. EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol. 2010;58:398–406.PubMedCrossRef Ljungberg B, Cowan NC, Hanbury DC, Hora M, Kuczyk MA, Merseburger AS, et al. EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol. 2010;58:398–406.PubMedCrossRef
2.
go back to reference Campbell SC, Novick AC, Belldegrun A, Blute ML, Chow GK, Derweesh IH, et al. Guideline for management of the clinical T1 renal mass. J Urol. 2009;182:9. Campbell SC, Novick AC, Belldegrun A, Blute ML, Chow GK, Derweesh IH, et al. Guideline for management of the clinical T1 renal mass. J Urol. 2009;182:9.
3.
go back to reference Thompson RH, Boorjian SA, Lohse CM, Leibovich BC, Kwon ED, Cheville JC, et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol. 2008;179:468–71. discussion 72–3.PubMedCrossRef Thompson RH, Boorjian SA, Lohse CM, Leibovich BC, Kwon ED, Cheville JC, et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol. 2008;179:468–71. discussion 72–3.PubMedCrossRef
4.
go back to reference Miller DC, Schonlau M, Litwin MS, Lai J, Saigal CS. Renal and cardiovascular morbidity after partial or radical nephrectomy. Cancer. 2008;112:511–20.PubMedCrossRef Miller DC, Schonlau M, Litwin MS, Lai J, Saigal CS. Renal and cardiovascular morbidity after partial or radical nephrectomy. Cancer. 2008;112:511–20.PubMedCrossRef
5.
go back to reference • Joniau S, Vander Eeckt K, Srirangam SJ, Van Poppel H. Outcome of nephron-sparing surgery for T1b renal cell carcinoma. BJU Int. 2009;103:1344–8. This study demonstrated the feasibility and good oncological results of NSS in T1b RCC.PubMedCrossRef • Joniau S, Vander Eeckt K, Srirangam SJ, Van Poppel H. Outcome of nephron-sparing surgery for T1b renal cell carcinoma. BJU Int. 2009;103:1344–8. This study demonstrated the feasibility and good oncological results of NSS in T1b RCC.PubMedCrossRef
6.
go back to reference Touijer K, Jacqmin D, Kavoussi LR, Montorsi F, Patard JJ, Rogers CG, et al. The expanding role of partial nephrectomy: a critical analysis of indications, results, and complications. Eur Urol. 2010;57:214–22.PubMedCrossRef Touijer K, Jacqmin D, Kavoussi LR, Montorsi F, Patard JJ, Rogers CG, et al. The expanding role of partial nephrectomy: a critical analysis of indications, results, and complications. Eur Urol. 2010;57:214–22.PubMedCrossRef
7.
go back to reference Pahernik S, Roos F, Rohrig B, Wiesner C, Thuroff JW. Elective nephron sparing surgery for renal cell carcinoma larger than 4 cm. J Urol. 2008;179:71–4.PubMedCrossRef Pahernik S, Roos F, Rohrig B, Wiesner C, Thuroff JW. Elective nephron sparing surgery for renal cell carcinoma larger than 4 cm. J Urol. 2008;179:71–4.PubMedCrossRef
8.
go back to reference Gill IS, Kavoussi LR, Lane BR, Blute ML, Babineau D, Colombo Jr JR, et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol. 2007;178:41–6.PubMedCrossRef Gill IS, Kavoussi LR, Lane BR, Blute ML, Babineau D, Colombo Jr JR, et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol. 2007;178:41–6.PubMedCrossRef
9.
go back to reference Marszalek M, Meixl H, Polajnar M, Rauchenwald M, Jeschke K, Madersbacher S. Laparoscopic and open partial nephrectomy: a matched-pair comparison of 200 patients. Eur Urol. 2009;55:1171–8.PubMedCrossRef Marszalek M, Meixl H, Polajnar M, Rauchenwald M, Jeschke K, Madersbacher S. Laparoscopic and open partial nephrectomy: a matched-pair comparison of 200 patients. Eur Urol. 2009;55:1171–8.PubMedCrossRef
10.
go back to reference Simmons MN, Gill IS. Decreased complications of contemporary laparoscopic partial nephrectomy: use of a standardized reporting system. J Urol. 2007;177:2067–73.PubMedCrossRef Simmons MN, Gill IS. Decreased complications of contemporary laparoscopic partial nephrectomy: use of a standardized reporting system. J Urol. 2007;177:2067–73.PubMedCrossRef
11.
go back to reference Wille AH, Tullmann M, Roigas J, Loening SA, Deger S. Laparoscopic partial nephrectomy in renal cell cancer–results and reproducibility by different surgeons in a high volume laparoscopic center. Eur Urol. 2006;49:337–42.PubMedCrossRef Wille AH, Tullmann M, Roigas J, Loening SA, Deger S. Laparoscopic partial nephrectomy in renal cell cancer–results and reproducibility by different surgeons in a high volume laparoscopic center. Eur Urol. 2006;49:337–42.PubMedCrossRef
12.
go back to reference Haber GP, Gill IS. Laparoscopic partial nephrectomy: contemporary technique and outcomes. Eur Urol. 2006;49:660–5.PubMedCrossRef Haber GP, Gill IS. Laparoscopic partial nephrectomy: contemporary technique and outcomes. Eur Urol. 2006;49:660–5.PubMedCrossRef
13.
go back to reference Gill IS, Matin SF, Desai MM, Kaouk JH, Steinberg A, Mascha E, et al. Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumors in 200 patients. J Urol. 2003;170:64–8.PubMedCrossRef Gill IS, Matin SF, Desai MM, Kaouk JH, Steinberg A, Mascha E, et al. Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumors in 200 patients. J Urol. 2003;170:64–8.PubMedCrossRef
14.
go back to reference Fergany AF, Saad IR, Woo L, Novick AC. Open partial nephrectomy for tumor in a solitary kidney: experience with 400 cases. J Urol. 2006;175:1630–3.PubMedCrossRef Fergany AF, Saad IR, Woo L, Novick AC. Open partial nephrectomy for tumor in a solitary kidney: experience with 400 cases. J Urol. 2006;175:1630–3.PubMedCrossRef
15.
go back to reference Marberger M. Renal ischaemia: not a problem in laparoscopic partial nephrectomy? BJU Int. 2007;99:3–4.PubMedCrossRef Marberger M. Renal ischaemia: not a problem in laparoscopic partial nephrectomy? BJU Int. 2007;99:3–4.PubMedCrossRef
16.
go back to reference Thompson RH, Frank I, Lohse CM, Saad IR, Fergany A, Zincke H, et al. The impact of ischemia time during open nephron sparing surgery on solitary kidneys: a multi-institutional study. J Urol. 2007;177:471–6.PubMedCrossRef Thompson RH, Frank I, Lohse CM, Saad IR, Fergany A, Zincke H, et al. The impact of ischemia time during open nephron sparing surgery on solitary kidneys: a multi-institutional study. J Urol. 2007;177:471–6.PubMedCrossRef
17.
go back to reference Shikanov S, Lifshitz D, Chan AA, Okhunov Z, Ordonez MA, Wheat JC, et al. Impact of ischemia on renal function after laparoscopic partial nephrectomy: a multicenter study. J Urol. 2010;183:1714–8.PubMedCrossRef Shikanov S, Lifshitz D, Chan AA, Okhunov Z, Ordonez MA, Wheat JC, et al. Impact of ischemia on renal function after laparoscopic partial nephrectomy: a multicenter study. J Urol. 2010;183:1714–8.PubMedCrossRef
18.
go back to reference • La Rochelle J, Shuch B, Riggs S, Liang LJ, Saadat A, Kabbinavar F, et al. Functional and oncological outcomes of partial nephrectomy of solitary kidneys. J Urol. 2009;181:2037–42. This study evaluated the outcome of partial nephrectomy in solitary kidneys and demonstrated the detrimental effect of ischemia on renal function.PubMedCrossRef • La Rochelle J, Shuch B, Riggs S, Liang LJ, Saadat A, Kabbinavar F, et al. Functional and oncological outcomes of partial nephrectomy of solitary kidneys. J Urol. 2009;181:2037–42. This study evaluated the outcome of partial nephrectomy in solitary kidneys and demonstrated the detrimental effect of ischemia on renal function.PubMedCrossRef
19.
go back to reference Wszolek MF, Kenney PA, Lee Y, Libertino JA. Comparison of hilar clamping and non-hilar clamping partial nephrectomy for tumours involving a solitary kidney. BJU Int. 2011;107:1886–92.PubMedCrossRef Wszolek MF, Kenney PA, Lee Y, Libertino JA. Comparison of hilar clamping and non-hilar clamping partial nephrectomy for tumours involving a solitary kidney. BJU Int. 2011;107:1886–92.PubMedCrossRef
20.
go back to reference Janetschek G. Laparoscopic partial nephrectomy for RCC: how can we avoid ischemic damage of the renal parenchyma? Eur Urol. 2007;52:1303–5.PubMedCrossRef Janetschek G. Laparoscopic partial nephrectomy for RCC: how can we avoid ischemic damage of the renal parenchyma? Eur Urol. 2007;52:1303–5.PubMedCrossRef
21.
go back to reference Gill IS, Desai MM, Kaouk JH, Meraney AM, Murphy DP, Sung GT, et al. Laparoscopic partial nephrectomy for renal tumor: duplicating open surgical techniques. J Urol. 2002;167(2 Pt 1):469–76.PubMed Gill IS, Desai MM, Kaouk JH, Meraney AM, Murphy DP, Sung GT, et al. Laparoscopic partial nephrectomy for renal tumor: duplicating open surgical techniques. J Urol. 2002;167(2 Pt 1):469–76.PubMed
22.
go back to reference Gill IS, Abreu SC, Desai MM, Steinberg AP, Ramani AP, Ng C, et al. Laparoscopic ice slush renal hypothermia for partial nephrectomy: the initial experience. J Urol. 2003;170:52–6.PubMedCrossRef Gill IS, Abreu SC, Desai MM, Steinberg AP, Ramani AP, Ng C, et al. Laparoscopic ice slush renal hypothermia for partial nephrectomy: the initial experience. J Urol. 2003;170:52–6.PubMedCrossRef
23.
go back to reference Janetschek G, Abdelmaksoud A, Bagheri F, Al-Zahrani H, Leeb K, Gschwendtner M. Laparoscopic partial nephrectomy in cold ischemia: renal artery perfusion. J Urol. 2004;171:68–71.PubMedCrossRef Janetschek G, Abdelmaksoud A, Bagheri F, Al-Zahrani H, Leeb K, Gschwendtner M. Laparoscopic partial nephrectomy in cold ischemia: renal artery perfusion. J Urol. 2004;171:68–71.PubMedCrossRef
24.
go back to reference Nguyen MM, Gill IS. Halving ischemia time during laparoscopic partial nephrectomy. J Urol. 2008;179:627–32.PubMedCrossRef Nguyen MM, Gill IS. Halving ischemia time during laparoscopic partial nephrectomy. J Urol. 2008;179:627–32.PubMedCrossRef
25.
go back to reference • Gill IS, Kamoi K, Aron M, Desai MM. 800 Laparoscopic partial nephrectomies: a single surgeon series. J Urol. 2010;183(1):34–41. This study demonstrates the evolvement of laparoscopic partial nephrectomie and surgical outcomes over the decade.PubMedCrossRef • Gill IS, Kamoi K, Aron M, Desai MM. 800 Laparoscopic partial nephrectomies: a single surgeon series. J Urol. 2010;183(1):34–41. This study demonstrates the evolvement of laparoscopic partial nephrectomie and surgical outcomes over the decade.PubMedCrossRef
26.
go back to reference Breda A, Finelli A, Janetschek G, Porpiglia F, Montorsi F. Complications of laparoscopic surgery for renal masses: prevention, management, and comparison with the open experience. Eur Urol. 2009;55:836–50.PubMedCrossRef Breda A, Finelli A, Janetschek G, Porpiglia F, Montorsi F. Complications of laparoscopic surgery for renal masses: prevention, management, and comparison with the open experience. Eur Urol. 2009;55:836–50.PubMedCrossRef
27.
go back to reference Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182:844–53.PubMedCrossRef Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182:844–53.PubMedCrossRef
28.
go back to reference Weight CJ, Fergany AF, Gunn PW, Lane BR, Novick AC. The impact of minimally invasive techniques on open partial nephrectomy: a 10-year single institutional experience. J Urol. 2008;180:84–8.PubMedCrossRef Weight CJ, Fergany AF, Gunn PW, Lane BR, Novick AC. The impact of minimally invasive techniques on open partial nephrectomy: a 10-year single institutional experience. J Urol. 2008;180:84–8.PubMedCrossRef
29.
go back to reference Hafez KS, Fergany AF, Novick AC. Nephron sparing surgery for localized renal cell carcinoma: impact of tumor size on patient survival, tumor recurrence and TNM staging. J Urol. 1999;162:1930–3.PubMedCrossRef Hafez KS, Fergany AF, Novick AC. Nephron sparing surgery for localized renal cell carcinoma: impact of tumor size on patient survival, tumor recurrence and TNM staging. J Urol. 1999;162:1930–3.PubMedCrossRef
30.
go back to reference Shapiro E, Benway BM, Wang AJ, Bhayani SB. The role of nephron-sparing robotic surgery in the management of renal malignancy. Curr Opin Urol. 2009;19:76–80.PubMedCrossRef Shapiro E, Benway BM, Wang AJ, Bhayani SB. The role of nephron-sparing robotic surgery in the management of renal malignancy. Curr Opin Urol. 2009;19:76–80.PubMedCrossRef
Metadata
Title
Partial Nephrectomy: Is There Still a Need for Open Surgery?
Authors
Varun Sharma
Markus Margreiter
Publication date
01-02-2013
Publisher
Current Science Inc.
Published in
Current Urology Reports / Issue 1/2013
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-012-0297-2

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