Laparoscopic enucleation of renal masses

Abstract

Introduction: Tumor Enucleation (TE) of renal masses as an alternative of nephron-sparing surgery has increased in the past years. Objectives: To describe the perioperative, oncological and functional outcomes of laparoscopic TE in a series of patients with renal masses. Material and method: A descriptive and retrospective study of 71 patients who underwent laparoscopic TE surgery for renal mass in La Habana, Cuba at the Centro Nacional de Cirugía de Mínimo Acceso, between 2010 and 2019. Clinical-epidemiological and perioperative variables, complications, Clavien-Dindo grade and oncological variables were considered. The SPSS program, version 23.0 was utilized. Frequencies, mean percentages, standard deviation and Student´s t- test (p<0.05) were estimated. Survival was appraised by using the Kaplan Meier curve. Results: Mean age was 58 years. Male patients prevailed (60.6%), with comorbidities (87.3%), incidental diagnosis (73.2%), low complexity tumors (64.8%). Mean tumor size and RENAL score was 33.6 mm and 6.1, respectively. Hand-assisted transperitoneal approach was performed (92.9%), mean bleeding was 335.9 ml and length of hospital stay 5.2 days. Postoperative renal function was preserved (p=0.082). Postoperative complications prevailed (14.1%), bleeding (8.4%) and grade II and IV (4.2%, respectively). Most masses were malignant (71.8%), ccRC prevailed (52.1%), pT1a (78.4%), overall survival and cancer specific survival was 100% and 96.0%, respectively. Mean follow-up time was 7.4 years. Conclusions: Laparoscopic TE is a feasible alternative for treating select renal masses, with satisfactory perioperative, oncological and functional outcomes.