Study objective: To evaluate the benefits obtained during the learning phase of laparoscopic nephrectomy (LN) for clinical stage cT1 and cT2 renal cancers.
Patients and methods: We retrospectively compared our first 25 cases of LN (13 right, 12 left) with 32 nephrectomies performed by Conventional Surgery (CS) (17 right, 15 left) between May 2000 and December 2001. The LN group comprised 18 men and 7 women with a mean age of 63.8 years. The CS group comprised 18 men and 14 women with a mean age of 67.7 years. Preoperative, intraoperative, postoperative and histological parameters were compared by analysis of the variance or nonparametric Mann-Whitney U test for quantitative variables and Chi-square test for qualitative data.
Results: Preoperative and histological parameters, blood loss, quantity and duration of analgesics and the complication rate were similar in the two groups. Resection was complete in every case. The mean duration of radical nephrectomy was significantly shorter by CS (p < 0.001). Return of bowel sounds was more rapid (p = 0.002) and patients were discharged from hospital earlier (p = 0.004) after LN.
Conclusion: Laparoscopic nephrectomy for cancer must be performed by an operator experienced in laparoscopy. During the learning phase, this procedure provided benefits in terms of return of bowel sounds and length of hospital stay, which should encourage teams performing laparoscopy to perform radical nephrectomy by laparoscopy.