Laparoscopic partial nephrectomy for large renal masses: results of a European survey

Objective To evaluate the perioperative effectiveness of laparoscopic partial nephrectomy (LPN) for large (4–7 cm) renal masses, with a review of the experience of six European advanced laparoscopic centres. Patients and methods A survey was planned; data were extracted from each institutional data base to obtain information about patients who had undergone LPN for renal masses larger than 4 cm. Demographic, radiological growth patterns of the tumours and intraoperative data were collected. Post-operative complications and pathological data were also recorded. All data were processed through statistical software. Results Data on 63 patients were collected. Radiological tumour size was 4.7 cm (4.1–7), growth pattern was cortical in 33 cases and cortico-medullar in 30 cases. Warm ischemia time (WIT) was 25.7 min in 7.3% cases bleeding occurred intra-operatively, post-operative surgical complications occurred in 14.6% cases. Pathological analyses revealed malignant lesion in 73% and positive margins in 6.5%. Complications and positive margins are more frequent for cortico-medullar lesions. Conclusions This survey confirms that LPN for tumours 4–7 cm in size is feasible in experienced hands. WIT and overall complication rate remain questionable points.