Laparoscopic versus open partial nephrectomy for clinical T1 renal masses: no impact of surgical approach on perioperative complications and long-term postoperative quality of life

Springer Science and Business Media LLC - Tập 33 - Trang 421-426 - 2014
Andreas Becker1,2, Lea Pradel1, Luis Kluth1, Marianne Schmid1, Christian Eichelberg1, Sascha Ahyai1, Quoc Trinh3,4, Daniel Seiler5, Roland Dahlem1, Jens Hansen1, Michael Rink1, Mario Zacharias6, Anja Mehnert7, Corinna Bergelt7, Margit Fisch1, Felix K. H. Chun1
1Department of Urology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
2Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada
3Division of Urology, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
4Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
5Department of Urology, Kantonsspital Aarau, Aarau, Switzerland
6Department of Urology, Vivantes Auguste-Victoria-Klinikum, Berlin, Germany
7Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

Tóm tắt

Beyond oncological safety, consideration of 30-day complications according to Clavien–Dindo, as well as postoperative quality of life (QoL) after nephron-sparing surgery for clinical T1 renal masses, represents important factors for treatment decision counseling. The objective of this study was to compare the effect of laparoscopic versus open partial nephrectomy (LPN vs. OPN) on 30-day complications and long-term postoperative QoL for clinical T1 renal masses. Retrospective, longitudinal analysis of 293 patients treated with either LPN versus OPN for T1 renal masses. The investigated endpoints were 30-day Clavien–Dindo complications and health-related QoL (EORTC QLQ-C30). Respectively, logistic and linear regression models analyzed the effect of surgical partial nephrectomy approach on endpoints. Overall complication rates were similar in patients undergoing OPN or LPN (16.1 vs. 14.6 %, p = 0.8). Significantly less major complications (2.4 vs. 10.4 %, p = 0.025) occurred after LPN. Despite a shorter convalescence period for LPN patients (p = 0.035), in uni- and multivariable analyses, surgical approach was not associated with 30-day complications nor long-term differences in QoL (all p > 0.05). Despite a faster recovery time after LPN, our findings suggest that LPN and OPN are equivalent with regard to 30-day Clavien–Dindo complication rates and long-term QoL.

Tài liệu tham khảo