Laparoscopic Partial Nephrectomy: Ready for Prime Time

ObjectivesTo review the development, techniques, outcomes, and current status of laparoscopic partial nephrectomy (LPN) for renal tumours.MethodsA Medline search (1996–2006) was performed using the following keywords: kidney, laparoscopic partial nephrectomy, renal, and tumour. Over 300 papers were identified. Of these, 47 papers were selected for review based on their contribution to evolution of concepts, development of techniques, and perioperative and oncologic outcomes after LPN.ResultsLPN provides perioperative results as well as intermediate and long-term oncologic and functional outcomes comparable to the reference standard (open partial nephrectomy [OPN]) with significantly decreased patient morbidity. The 5-yr oncologic data are available for 50 patients, with a mean tumour size of 3 cm (range 1.4–7 cm). Renal cell carcinoma (RCC) was confirmed in 64% with tumour stage pT1a in 91%. At a median follow-up of 5.2 yr, overall and cancer-specific survival rates were 84% and 100%, respectively.ConclusionsAs global experience and skills with this technique increase, the number of patients undergoing this procedure is increasing rapidly. In expert hands, cancer control and functional outcomes are comparable to OPN.