Abstract
We retrospectively analyzed the clinical results for 121 patients with renal tumor who underwent laparoscopic nephrectomy at the University of Fukui between January 2002 and December 2012. Patients were retrospectively divided chronologically into 4 eras, as follows : era 1 : initial 16 cases ; era 2 : 33 cases, hand-assisted nephrectomy was mainly performed ; era 3 : 18 patients, procedure was performed by one of 2 fixed surgeons ; and era 4 : 54 patients, procedure was performed by surgeons under the direction of surgeons certified by the Endoscopic Surgical Skill Qualification System in urological laparoscopy. For these eras, the mean tumor sizes were 5.0, 4.3, 3.2, 3.7 cm, the median operating times were 224, 216, 186, and 202 min, the estimated blood losses were 140, 100, 28 and 20 ml, and the conversions to an open procedure were 12.5%, 0%, 5.5%, 7.4%, respectively. In the 103 renal cancer patients without metastasis, the 5-year recurrence-free survival rate and cause-specific survival rate were 89.4% and 96.7%, respectively.
