Liangsong Zhu1, Guangyu Wu2, Jiwei Huang1, Jianfeng Wang1, Ruiyun Zhang1, Wen Kong1, Wei Xue1, Yiran Huang1, Yonghui Chen3, Jin Zhang4. 1. Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China. 2. Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China. 3. Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China. cyh1488@163.com. 4. Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, People's Republic of China. med-zhangjin@vip.sina.com.
Abstract
PURPOSE: To compare the renal function preservation between laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy. METHODS: Data were analyzed from 246 patients who underwent laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy for solitary cT1a renal cell carcinoma from January 2013 to July 2015. To reduce the intergroup difference, we used a 1:1 propensity matching analysis. The functional renal parenchyma volume preservation were measured preoperative and 12 months after surgery. The total renal function recovery and spilt GFR was compared. Multivariable logistic analysis was used for predictive factors for renal function decline. RESULTS: After 1:1 propensity matching, each group including 100 patients. Patients in the laparoscopic radio frequency ablation assisted tumor enucleation had a smaller decrease in estimate glomerular filtration rate at 1 day (-7.88 vs -20.01%, p < 0.001), 3 months (-2.31 vs -10.39%, p < 0.001), 6 months (-2.16 vs -7.99%, p = 0.015), 12 months (-3.26 vs -8.03%, p = 0.012) and latest test (-3.24 vs -8.02%, p = 0.040), also had better functional renal parenchyma volume preservation (89.19 vs 84.27%, p < 0.001), lower decrease of the spilt glomerular filtration rate (-9.41 vs -17.13%, p < 0.001) at 12 months. The functional renal parenchyma volume preservation, warm ischemia time and baseline renal function were the important independent factors in determining long-term functional recovery. CONCLUSIONS: The laparoscopic radio frequency ablation assisted tumor enucleation technology has unique advantage and potential in preserving renal parenchyma without ischemia damage compared to conventional laparoscopic partial nephrectomy, and had a better outcome, thus we recommend this technique in selected T1a patients.
PURPOSE: To compare the renal function preservation between laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy. METHODS: Data were analyzed from 246 patients who underwent laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy for solitary cT1a renal cell carcinoma from January 2013 to July 2015. To reduce the intergroup difference, we used a 1:1 propensity matching analysis. The functional renal parenchyma volume preservation were measured preoperative and 12 months after surgery. The total renal function recovery and spilt GFR was compared. Multivariable logistic analysis was used for predictive factors for renal function decline. RESULTS: After 1:1 propensity matching, each group including 100 patients. Patients in the laparoscopic radio frequency ablation assisted tumor enucleation had a smaller decrease in estimate glomerular filtration rate at 1 day (-7.88 vs -20.01%, p < 0.001), 3 months (-2.31 vs -10.39%, p < 0.001), 6 months (-2.16 vs -7.99%, p = 0.015), 12 months (-3.26 vs -8.03%, p = 0.012) and latest test (-3.24 vs -8.02%, p = 0.040), also had better functional renal parenchyma volume preservation (89.19 vs 84.27%, p < 0.001), lower decrease of the spilt glomerular filtration rate (-9.41 vs -17.13%, p < 0.001) at 12 months. The functional renal parenchyma volume preservation, warm ischemia time and baseline renal function were the important independent factors in determining long-term functional recovery. CONCLUSIONS: The laparoscopic radio frequency ablation assisted tumor enucleation technology has unique advantage and potential in preserving renal parenchyma without ischemia damage compared to conventional laparoscopic partial nephrectomy, and had a better outcome, thus we recommend this technique in selected T1apatients.
Authors: Hyun Chul Chung; Tae Wook Kang; Joon Young Lee; Eu Chang Hwang; Hong Jun Park; Jun Eul Hwang; Ki Don Chang; Young Hwan Kim; Jae Hung Jung Journal: Investig Clin Urol Date: 2022-03