Effect Of Tumor Size

Steinberg et al. (Steinberg AP, Matin SF, Gill IS. Effect of tumor size on laparoscopic partial nephrectomy. Personal communication) evaluated the effect of tumor size by retrospectively dividing 100 patients undergoing laparoscopic partial nephrectomy into three groups: patients with a tumor <2 cm in size (group I, n = 15); patients with a tumor size of 2-4 cm (group II, n = 76); and patients with a tumor size >4 cm (group III, n = 9). Comparing groups I, II, and III, increasing tumor size associated with significantly longer operative time (2.9 vs. 3.1 vs. 3.9 hours, respectively; p = 0.03), greater blood loss (75 vs. 150 vs. 200 mL, respectively; p = 0.001), more frequent need of collecting system entry and suture repair (47% vs. 64% vs. 89%, respectively; p = 0.004), and higher incidence of complications (13% vs. 25% vs. 33%, respectively; p = 0.02). No differences were noted in terms of warm ischemia time (p = 0.65) and hospital stay (p = 0.16). Pathology showed renal cancer case in 53%, 74%, and 67% of patients in group I, II, and III, respectively (p = 0.33). The authors concluded that laparoscopic partial nephrectomy could be performed safely and effectively for select patients with a tumor larger than 2 cm in size.

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