1000 SURGICAL MARGINS AFTER LAPAROSCOPIC PARTIAL NEPHRECTOMY: SINGLE SURGEON EXPERIENCE (2010)

You have accessJournal of UrologyKidney Cancer: Localized II1 Apr 20101000 SURGICAL MARGINS AFTER LAPAROSCOPIC PARTIAL NEPHRECTOMY: SINGLE SURGEON EXPERIENCE Francesco Porpiglia, Cristian FIori, Riccardo Bertolo, Enrico Bollito, Mauro Papotti, and Roberto Mario Scarpa Francesco PorpigliaFrancesco Porpiglia More articles by this author , Cristian FIoriCristian FIori More articles by this author , Riccardo BertoloRiccardo Bertolo More articles by this author , Enrico BollitoEnrico Bollito More articles by this author , Mauro PapottiMauro Papotti More articles by this author , and Roberto Mario ScarpaRoberto Mario Scarpa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1969AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The purpose of this study is to explore the pathological outcomes of laparoscopic partial nephrectomy (LPN) for kidney tumour performed by a single surgeon in a single Institution. METHODS We retrospectively reviewed our prospectively maintained LPN data base and we have reviewed the pathological specimen of kidney tumour treated with LPN at our Institution by a single surgeon (FP) from January 2001 to September 2009. A single uro-pathologist (EB) performed pathological analyses. The masses were divided into three Groups with a chronologic criterion: cases from 1 to 45 were assigned to Group A, from 46 to 90 were assigned to Group B whilst the remainder 44 cases (from 91 to 134) were assigned to group C. The three groups were compared according the following variables: lesion size at Computed Tomography scans (CT-scan size), pathological size and weight, staging according to TNM, minimum and maximum resection margins, differential between minimum and maximum resection margin, mean of excised margin and percentage of positive surgical margins (PSM). A p-value < 0.05 was considered statistically significant. RESULTS Groups were similar in terms of CT-scan and pathological size (p>0.05); we registered an increase in the pathological weight of the lesions in Group C respect to Groups A and B (p=0.002). Of the 134 lesions, 89 were defined malignant at the pathological analysis: the 57.7% (26/45), 64.8% (31/45) and 75% (33/44), in Groups A, B and C, respectively. The distribution of malignant lesions stratified according to pathological TNM staging was: 59/89 (66%) pT1a, 25/89 (28%) pT1b, 2/89 (2%) pT2, 4/89 (4%) pT3a; we did not found statistically significant difference in the distribution of TNM staging inside the Groups (p>0.05). Respect to Groups A and B, similar for each variable, we found differences among these Groups and Group C in terms of minimum (p < 0.001) and maximum resection margin (p < 0.012) and in the mean rim of healthy renal tissue removed during partial nephrectomy. (p < 0.04). Only the differential measurement between minimum and maximum resection margin remained unchanged along the whole case study (p>0.05). There was no statistically significant difference in the percentage of PSM among the Groups, with an overall rate of 2.2% (3/134); in particular no PSM were recorded in Group C. CONCLUSIONS Our data suggest as, with the increase of surgeon experience, the amount of healthy tissue removed during LPN decreases and this could be reduce kidney damage. Moreover the reduction of this peri-tumoral tissue does not impair the oncological effectiveness of the procedure. Orbassano (Torino), Italy© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e389 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francesco Porpiglia More articles by this author Cristian FIori More articles by this author Riccardo Bertolo More articles by this author Enrico Bollito More articles by this author Mauro Papotti More articles by this author Roberto Mario Scarpa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...