IMPLEMENTATION OF LAPAROSCOPIC APPROACH IN A KIDNEY CANCER SURGERY - A SINGLE CANCER’S CENTER EXPERIENCE

Renal cell cancer or renal cell carcinoma (RCC) is the most common type of kidney cancer in adults. In Russia (2017 year) it accounts for approximately 3.7% of adult malignancies.Laparoscopic radical nephrectomy (LRN) now is a gold standard in treatment of renal cell carcinoma (RCC) in the world. In Russia laparoscopic nephrectomy (radical and partial) have been commonly performed at a large multicenter hospitals with the large number of patients and relatively rare at single regional cancer centers. Implementation of laparoscopic approach in a renal cell cancer surgery in a safe and timely manner will improve quality and accessibility of minimally invasive surgery in a regional cancer centers. Aims: evaluate complication rate, surgical operation time, mortality rate implementing minimally invasive surgical technique in renal cell cancer surgery - a single cancer’s center experience. Summary: 174 patients underwent surgery using laparoscopic technique for renal cell cancer. All patients were divided on 2 equal groups, depending on the time required to master laparoscopic technique. Outcome measures included operation time, conversion rate, blood loss, mortality rate, readmission and postoperative complication rates and time of impatient care. Result: Main outcome variables(operation time, conversion rate, time of impatient care, mortality rates, postoperative complication rates) reach a plateau in the learning curve after 94 operation. It is important to mention that during the whole period of implementing laparoscopic technique for renal cell cancer postoperative complication rates, mortality rates and operation time were comparable with the data available in the literature. Conclusion: It is shown that the introduction of minimally invasive technologies into a renal cell cancer surgery is relatively safe and possible under the given conditions, while the time of mastering laparoscopic technique in regional cancer center is comparable with the data available in the literature.

oncology, urology, renal cell cancer, minimally invasive surgery, laparoscopy, learning curve, implementation of surgery technique, regional cancer center