Retroperitoneal Laparoscopic Nephrotomy Along the Brodel Line and Tumor Enucleation for Complete Intraparenchymal Renal Tumors: A Single Institution Experience

Abstract

Purpose:

To evaluate the feasibility and outcomes of retroperitoneal laparoscopic nephrotomy along the Brodel line and tumor enucleation (TE) for complete intraparenchymal renal tumors.

Patients and Methods:

We retrospectively analyzed the medical charts of patients with complete endophytic tumors and who underwent retroperitoneal laparoscopic nephrotomy along the Brodel line and TE between 2012 and 2015. Perioperative data, surgical technique, pathologic variables, complications, functional, and oncologic outcomes were reviewed.

Results:

Twenty-one patients (mean age of 50 years; mean body mass index of 25.8 kg/m²) were treated with retroperitoneal laparoscopic TE along the Brodel line incision. The mean tumor size was 2.0 cm, and the mean RENAL score was 9.4. The main surgical outcomes were mean operative time of 94 minutes, mean estimated blood loss of 63 mL, and mean warm ischemia time of 28.4 minutes. Pathology showed clear renal cell carcinoma (n = 16), papillary renal cell carcinoma (n = 4), and reninoma (n = 1). No positive margin was found, and no perioperative complication occurred. The mean glomerular filtration rate of the affected kidney was 31.5 mL/minute/1.73 m² three months after the surgery. In a median follow-up of 20 months (range of 4–36 months), no evidence of tumor recurrence or metastasis was found.

Conclusion:

For patients with complete intraparenchymal renal tumors, retroperitoneal laparoscopic parenchyma incision along the Brodel line and TE can be safely and effectively performed in centers with significant laparoscopic expertise.