Laparoscopic resection of isolated fossa recurrence of renal cell carcinoma after open nephrectomy: report of 6 cases and literature review

Arch Esp Urol. 2014 Apr;67(3):277-83.
[Article in English, Spanish]

Abstract

Objectives: Local recurrence after a correct surgical technique and absence of distant metastasis is a rare occurrence after radical nephrectomy. Surgical resection remains the standard management for this pathological setting. Nevertheless controversy persists over surgical approach and adjuvant treatments.

Methods: We report on perioperative outcomes of a small multi-institutional series of patients with fully laparoscopic management of isolated renal fossa recurrence following open radical nephrectomy.

Results: All patients underwent full laparoscopic surgery. Mean operative time was 140 minutes (range 75 to 240 minutes). Only one patient had a Clavien Grade IIIa complication. Mean hospital stay was 3 days (range 2 to 4 days). Out of the six patients, 5 had a mean follow-up of 20 months (range 9 to 32 months). Only one of these patients evolved with distant metastasis after surgery.

Conclusions: Laparoscopic resection of local recurrence after open radical nephrectomy is a challenging but reproducible technique. There is still no consensus or an operative protocol for this clinical setting. However, as long as surgery is kept within the possibilities, a laparoscopic approach should be sought.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Renal Cell / secondary*
  • Carcinoma, Renal Cell / surgery
  • Diaphragm / injuries
  • Female
  • Humans
  • Intraoperative Complications
  • Kidney Neoplasms / surgery*
  • Laparoscopy / methods*
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery*
  • Nephrectomy*
  • Retroperitoneal Neoplasms / secondary*
  • Retroperitoneal Neoplasms / surgery
  • Treatment Outcome