Surgical Management of Renal Cell Carcinoma: Comparisons of open versus laparoscopic approach

Abstract

Objectives: Renal Cell Carcinoma (RCC) is one of the foremost urological malignancies. In Oman, an age-standardized incidence rate of 2.5 per 100,000 per year is reported. There is a trend towards early detection and use of minimally invasive technology for the treatment of RCC. Aim of our study was to report the changing trend in clinical presentation and RCC management, including to compare the outcomes of laparoscopic versus open nephrectomy in Oman. Methods: After ethical committee’s approval, the bio-data for adult patients and peri-operative details were collected, who were diagnosed with RCC between 2011 and 2022. We analyze the variables, both continuous and categorical by Chi-square analysis. The p-value <0.05 was set as a level of significance. Results: Fifty-six patients underwent surgical treatment of RCC. Among them, 34 patients underwent laparoscopic nephrectomy (LN) and 22 open nephrectomy (ON). The mean age in the LN group was 53.82 years ± 13.44, and 56.2 years ± 15 (p-value 0.535) in ON group. Forty-seven patients were of Omani descent and 9 patients were expatiates. The mean tumor size was 6.25 ± 3.16 and 9.2 ± 5.20 cm for the LN and ON groups, respectively.  More than 55% cases were incidentally diagnosed. Over the years there has been a trend towards LN. Conclusion: In our study, we found a trend towards early diagnosis with majority of cancers discovered incidentally. We also recognized that laparoscopic approach is more commonly employed in the surgical management with acceptable morbidity. These trends are in congruence with the global literature.

Keywords: nephrectomy, laparoscopic, open, renal cell carcinoma