Improved closure techniques for laparoscopic partial nephrectomy in moderately complex renal cell carcinoma

摘要

Laparoscopic partial nephrectomy (LPN) as a minimally invasive nephron-sparing surgery is gradually becoming the preferred surgical treatment for T1a renal carcinoma since it yields faster post-operative recovery and equivalent oncological outcomes to radical nephrectomy.[1] However, it is difficult to perform LPN for complex renal tumors, resulting in a longer warm ischemic time (WIT), which consequently affects the recovery of post-operative renal function.[2] With the development of laparoscopic instruments and techniques and the accumulating experience of surgeons, the WIT during LPN may be shortened using anatomy-based early unclamping (EUC)[1] after the placement of one or two running sutures on the tumor bed. In this study, we improved the closure techniques for LPN using EUC in patients with complex renal tumors and assessed their effectiveness.