Objectives:

to determine oncologic outcomes regarding tumor free edges and surgical complications in patients undergoing laparoscopic "Zero ischemia" partial nephrectomy and enucleation of renal tumor.

Methodology:

retrospective, observational, and comparative study, with a universe of patients from Los Angeles private clinic and Caja Nacional de Salud, Hospital Obrero Nº2, Cochabamba, Bolivia, who underwent laparoscopic partial nephrectomy, were grouped in two groups: Group I: partial nephrectomy and Group II: enucleation. The following were analyzed: tumor size and location, RENAL score, surgical time, bleeding, days of stay, complications and histopathological report. SPSS version 20 (IBM, Chicago, IL) was used for statistical analysis.

Results:

seventeen patients were evaluated, 3 were excluded due to completion of radical surgery, 6 partial nephrectomies (Group I) and 8 enucleations (Group II). Mean age 45.7 (± 8.6) vs 51.2 (± 6.3) years. Tumor size 7.8 (2.5-10) vs 3.2 (1-5.7) cm, The overall RENAL score of all patients was low to moderate, a separate analysis was performed, in group I, the distribution was low complexity 2 (33.3%), moderate n=1 (16.7%) and high n=3 (50%), in group II, low complexity n=5 (62.5%), moderate n=2 (25%), high complexity n=1 (12.5%). There were differences in favor of group II (enucleation) in terms of surgical time and transoperative bleeding, presenting only 1 case with urinary leakage, resolved with placement of a JJ catheter. In terms of surgical edges, there were 2 (14.2%) cases with positive edges, 1 for each approach, which are kept under close surveillance.

Conclusions:

laparoscopic approach is an option comparable to the open one, equal results were obtained with respect to oncologic control in relation to free edges and with fewer complications, although experience in laparoscopic surgery is required, as well as an increase in follow-up time and a greater number of cases.

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