Laparoscopic partial nephrectomy for renal masses: Effect of tumor location

Ramakrishna Venkatesh, Kyle Weld, Caroline D. Ames, Sherbourne R. Figenshau, Chandru P. Sundaram, Gerald L. Andriole, Ralph V. Clayman, Jaime Landman

Research output: Contribution to journalArticle

131 Scopus citations

Abstract

Objectives: To report our single institutional experience of laparoscopic partial nephrectomy (LPN) for enhancing renal masses and evaluate outcomes and histopathologic findings with respect to the location of the renal mass. Methods: A retrospective review of LPN for 123 renal masses completed by 7 urologists was performed. Of these lesions, 49 (40%) were exophytic, 19 (15.5%) endophytic, 47 (38%) mesophytic, and 8 (6.5%) were hilar. We defined exophytic as more than 60%, mesophytic as 40% to 60%, and endophytic as less than 40% of the renal mass protruding off the surface of the kidney on radiologic imaging studies. Hilar lesions were those located within 5 mm of the renal hilar structures, regardless of the surface characteristics. Results: The mean tumor size was 2.6 cm (range 1 to 9). Hilar vessel clamping was performed during 55 procedures (44.7%); the mean warm ischemia time was 27 minutes (range 12 to 52). On final histopathologic examination, 3 patients (2.5%) had positive tumor resection margins. Overall, 26 (20.6%) complications occurred. The complication rate was significantly less for patients who underwent LPN for an exophytic (10%) or a mesophytic (12.8%) mass than for those with an endophytic (47%) or a hilar (50%) mass. Histopathologic examination of the renal masses revealed malignant pathologic features in 86 (69%) and benign findings in 37 (31%). In our series, only 55% of exophytic tumors were malignant and, if malignant, were invariably low grade (96%). Conclusions: The complications of LPN and the malignancy rate of the renal lesions were related to the tumor location within the kidney.

Original languageEnglish (US)
Pages (from-to)1169-1174
Number of pages6
JournalUrology
Volume67
Issue number6
DOIs
StatePublished - Jun 1 2006

ASJC Scopus subject areas

  • Urology

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    Venkatesh, R., Weld, K., Ames, C. D., Figenshau, S. R., Sundaram, C. P., Andriole, G. L., Clayman, R. V., & Landman, J. (2006). Laparoscopic partial nephrectomy for renal masses: Effect of tumor location. Urology, 67(6), 1169-1174. https://doi.org/10.1016/j.urology.2006.01.089