ABSTRACT
Background: The role of the open approach for partial nephrectomy is currently called into question by laparoscopy, although comparative studies on this issue are limited.
Objective: To compare surgical and renal functional outcomes after open partial nephrectomy (OPN) and laparoscopic partial nephrectomy (LPN).
Methods: This prospective randomized clinical study has been carried out at Urology department, Zagazig University from January 2017 till September 2020 on 35 patients candidates for partial nephrectomy, 17 patients in OPN and 18 patients in LPN.
Results: In total, 28 patients in both treatment groups complete the study. There was no statistical significant difference in age, gender, Body Mass Index (BMI), tumor size, tumor laterality and RENAL nephrometry score between both treatment groups. Significant differences were found between OPN and LPN regarding operative time (172.14±18.88 versus 148.93±31.88 min; P=0.027), estimate blood loss (252.86±70.32 versus 196.43±61.47 ml; P=0.032) and hospital stay (4.36±0.74 versus 3.14±1.1 days; P=0.002). Ischemia time was slightly higher in LPN (19.57±3.08 versus 17.79±2.15 min) without Significant difference (P=0.087). Positive safety margin was not significantly different between cases treated with OPN (1 case, 7%) and LPN (2 cases, 14%) (P=0.5). No cases developed local or distant recurrence during follow up period.
Conclusions: For cT1 renal tumors of low complexity, laparoscopic and open partial nephrectomy have comparable surgical and renal functional outcomes. LPN offers a strong alternative to OPN with shorter surgery time, less blood loss, and shorter hospital stay with quicker convalescence, with equivalent ischemia time compared to OPN.