Laparoscopic vs Open Radical Nephrectomy for Renal tumors in resource limited countries.

Abstract

Objectives: To evaluate the perioperative efficacy of laparoscopic radical nephrectomy in comparison with open radical nephrectomy for the management of localized (T1bN0M0) renal cell tumor of less than 7cm. Study Design: Prospective, Comparative study. Setting: Armed force Institute of Urology (AFIU). Period: July 2020 – July 2024. Methods: 90 patients (mean age: 56 ± 2.5) with clinical stage T1bN0M0 renal cell carcinoma were treated using two different approaches i.e., laparoscopic radical nephrectomy in Group-I patients and Open radical nephrectomy in Group-II. The choice of the approach was non randomized and it was depended on patient preference and surgeon experience. Results: Mean age of the patients and mean tumor size was comparable in both groups. To assess the efficacy of both techniques, perioperative outcomes that include estimated blood loss, operative time, length of hospital stay, need of post-operative analgesics and convalesce time were compared. Patients in Group-I showed greater operative time but less estimated blood loss, shorter hospital stay, less need of analgesics and early recovery to normal activities compared to patients in group-II. Follow up of 18 months in each group showed no cancer specific mortality or local recurrence. Conclusion: Laparoscopic radical nephrectomy for clinical stage T1bN0M0 renal carcinoma is associated with better perioperative results and is more effective as compared to open radical nephrectomy approach.