Presented by: Murat Gülşen MD
Ondokuz Mayıs University, School of Medicine, Department of Urology

Introduction

Our objective in this study is to compare functional and oncological outcomes in patients with central kidney tumors versus polar kidney tumors.

Materials

Prospectively collected data of 597 consecutive patients undergoing laparoscopic partial nephrectomy (LPN) by a single surgeon in a tertiary-care center from November 2009 to March 2023 were retrospectively evaluated. Patients with bilateral or multiple renal tumors, graft, and horseshoe kidney, and missing data were excluded. 517 patients included in the study. R.E.N.A.L. nephrometry score was implemented to determine the complexity and localization of the tumors. The cohort was allocated into two groups. Group 1: 168 patients with centrally located renal tumors, group 2: 344 patients with polar renal tumors. Tumors exhibiting deep parenchymal involvement and demonstrating contact with or invasion into the collecting system or renal sinus were classified as central tumors. Tumors based at the renal hilum, in proximity to the hilar arteries, veins, or renal pelvis within a 5 mm range, also were categorized as central tumors. Demographics, perioperative and postoperative variables were compared between 2 groups.

Results

,

Age and gender were comparable between two groups. However, RENAL score and tumor size was higher in group 1. We favor transperitoneal access for the majority of central tumors. Warm ischemia time (WIT) was significantly higher in central tumors. Trifecta achievement rate and complication rate were comparable for both groups.

Conclusion

Although LPN is a more challenging approach in patients with central tumors. In high-volume centers, it may be achieved similar surgical outcomes as in patients with polar tumors.

Funding

None

Co-Authors

Murat Gülşen, MD
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, Turkey

Ertuğrul Köse, MD
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, Turkey

Mehmet Necmettin Mercimek, Associate Professor
Atasam Hospital Urology Clinic, Samsun, TURKEY

Yakup Bostancı, Professor
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, Turkey

Yarkın Kamil Yakupoğlu, Professor
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, Turkey

Şaban Sarıkaya, Professor
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, Turkey

Ender Özden, Professor
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, Turkey