Laparoscopic Kidney-Sparing Surgery for Renal Tumors

The medical records of patients receiving PN at our center (Department of Urology, Umberto I Hospital) over the last 10 years were retrospectively reviewed. Elective PN was offered to patients whose renal tumors were either solitary, solid masses or complicated renal cysts preoperatively classified as Bosniak type III or IV cysts, which were not located in the renal hilum or associated with central sinus invasion if patients had a normal contralateral kidney. After the operation, the pathological features were reviewed by an experienced pathologist according to the World Health Organization classification system. Angiomyolipomas (AMLs), oncocytomas, benign cystic nephromas, adenomas, hydatid cysts, and various other non-malignant lesions were classified as benign, whereas malignant lesions comprised clear cell, chromophobe, papillary, collecting duct, sarcomatoid variant, and multilocular cystic RCC. A total of 195 patients were identified who had undergone elective PN for a solitary renal mass with the intention of curing presumed RCC, and these patients were included in this retrospective study. During the study period, no patients had undergone surgery with the preoperative diagnosis of a benign lesion or urothelial carcinoma. No patients with a renal mass or metastases underwent biopsy or in vivo ablation. Consequently, we have not recommended active surveillance for small renal tumors presumed to be RCC. Furthermore, no patients had a known genetic predisposition to RCC or AMLs (such as von Hippel-Lindau disease, Birt-Hogg-Dube syndrome, or tuberous sclerosis). All operations were performed using the laparoscopic surgical technique with a transperitoneal or retroperitoneal approach based on the patient’s history of abdominal surgery, habitus, tumor location, and surgeon preference. Furthermore, for better preservation of renal function, the off-clamp technique was chosen in all cases. Signed informed consent was obtained from all the patients for the publication of this study and for processing their medical data.

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Baio R., Molisso G., Caruana C., Di Mauro U., Intilla O., Pane U., D’Angelo C., Campitelli A., Pentimalli F, & Sanseverino R. (2023). “To Be or Not to Be Benign” at Partial Nephrectomy for Presumed RCC Renal Masses: Single-Center Experience with 195 Consecutive Patients. Diseases, 11(1), 27.

Publication 2023

A 195 Abdominal Adenomas Angiomyolipomas Biopsy Birt hogg dube syndrome Cell Chromophobe Cystic Genetic predisposition Hydatid cysts Laparoscopic surgical technique Metastases Nephromas Oncocytomas Pathologist Patients Preservation Renal Renal tumors Retroperitoneal Sarcomatoid Sinus Surgeon Surgery Surgery diagnosis Tuberous sclerosis Tumor location Urothelial carcinoma Von hippel lindau disease

Corresponding Organization : University of Salerno

Other organizations : University of Malta, University of Siena

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Variable analysis

independent variables

Renal tumor characteristics (solitary, solid masses or complicated renal cysts preoperatively classified as Bosniak type III or IV cysts)
Tumor location (not located in the renal hilum or associated with central sinus invasion)

dependent variables

Pathological features of the removed lesions (benign or malignant)
Surgical approach (laparoscopic, transperitoneal or retroperitoneal)

control variables

Patients with normal contralateral kidney
Absence of genetic predisposition to renal cell carcinoma (RCC) or angiomyolipomas (AMLs)
Use of off-clamp technique for better preservation of renal function

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