Radiofrequency ablation assisted laparoscopic partial nephrecto my versus laparoscopic partial nephrecto my：a co mparison of perioperative and i nter mediate-ter m outco mes

Cai Longjun; Fu Yang; Zhang Gutian; Zhao Xiaozhi; Yang Rong; Xu Linfeng; Ji Changwei; Zhang Shiwei; Lian Huibo; Liu Tieshi; Qu Feng; Yan Xiang; Lan Houjin; Yao Linfang; Li Xiaogong; Gan Weidong; Guo Hongqian

Abstract：To introduce the clinical experience and effects of laparoscopic partial nephrecto my with ra-di ofrequency ablati on (RFA- LPN)and LPN in treat ment of patients with T1 renal cell carcino ma .Methods :1 06 pa-tients with T1 renal cell carcino ma who were treated with LPN or RFA- LPN ,fro m Aug .201 0 to Aug .201 2 were retrospecti vel y anal yzed .There were 54 patients incl uded in the LPN group (37 males and 1 7 fe males ,mean age [52.4 ±1 0.1 ]y ,average maxi mu m tu mor dia meter was [2.90 ±0.90 ]c m).There were 52 patients incl uded in the RFA- LPN group (34 males and 1 8 fe males ,mean age [55.3 ±1 0.2 ]y ,average maxi mu m tu mor dia meter was (3.04 ±0.97 ).All patients were foll o wed up with detecti on of seru m creatinine and calculated gl o merular filtrati on rate before and after operati on was anal yzed .Results :All the 1 06 cases were operated successfull y without conversi on to open surgery .The operati ve ti me was (1 31.0 ±29.6 )min in LPN group ,and all the patients in this group under-went the hilar cla mping with the average hilar cla mping ti me being (23.9 ±6.3 )min .The operati ve ti me was (1 1 1.0 ±28.2 )min in RFA- LPN group ,and 1 1 patients in this group under went the hilar cla mping with the average hilar cla mping ti me being (20.1 ±5.7 )min .The esti mated bl ood l oss was (264.0 ±85.1 )mL in LPN group and (21 3.8 ±91.8 )mL in RFA- LPN group (P <0.05 ).The postoperati ve hospital stay was (9 ±3 )days and (8.2 ±2.6 )days in LPN and RFA- LPN groups respecti vel y .In LPN group ,co mplicati ons occurred in 8 cases (1 4.8 %)(Clavien grade Ⅰ:5 cases ;Clavien grade Ⅱ:2 cases ;Clavien grade Ⅲ:1 case ).In the RFA- LPN group ,co mplicati ons oc-curred in 9 ccases (1 4.8 %)(Clavien grade Ⅰ:4 cases ;Clavien grade Ⅱ:3 cases ;Clavien grade Ⅲ:2 cases ).The patients in both LPN and RFA- LPN groups had nor mal renal functi on and had no tu mor recurrence or metastasis [mean foll o w- up ti me :(24.5 ±9.8 )months in LPN group ,and (21.3 ±5.7 )months in RFA- LPN group ).The SCr and e GFR in LPN group before and after operati on were (78.3 ±8.5 )μmol/L and (79.5 ±7.7 )μmol/L (P >0.05 ),and (82.7 ±8.5 )mL ??min-1 ??1.73 m-2 and (81.1 ±7.8 )mL ??min-1 ??1.73 m-2 (P >0.05 )respecti vel y .In RFA- LPN group ,the SCr and e GFR before and after operati on were (68.9 ±1 4.5 )μmol/L and (76.1 ±1 8.9 )μmol/L (P >0.05 ),and (73.4 ±9.3 )mL ??min-1 ??1.73 m-2 and (78.2 ±9.4 )mL ??min-1 ??1.73 m-2 (P >0.05 ) respecti vel y .Conclusions :Co mpared with the LPN ,RFA- LPN for renal cell carcino ma T1 is safe and effecti ve ,and can retain ki dney functi on .For RFA- LPN selecti on ,the indicati ons for surgery shoul d be strictl y foll o wed .