Abstract：Objective:To evaluate the safety and surgical outcomes of two types of renorrhaphy technique in retroperitoneal laparoscopic partial nephrectomy.Methods:A retrospective analysis of 314 patients with renal tumors in whom retroperitoneal laparoscopic partial nephrectomy(LPN) was performed with interrupted, figure-of-eight suture (n=136) and layered parenchymal suture (n=178) between March 2008 and January 2012. All procedures were performed by the same laparoscopic surgeon (X. Z.). Patient demographics, tumor characteristics, operative outcomes, and perioperative renal functions were compared.Results:The patients were followed up for a median period of 34 months in the interrupted, figure-of-eight suture group and 30 months in the layered parenchymal suture group. There was no significant differences between them with respect to patient age(P=0.064), body mass index (P= 0.611), operative time(P=0.196), estimated blood loss(P=0.824), complications intro(P=0.655) and post operation(P=0.135). Tumor size for layered parenchymal suture group was significantly larger than interrupted, figure-of-eight suture group (3.4∶2.6, P=0.008). Tumor location(P=0.396) and margin status(P=0.070) were comparable. The layered parenchymal suture group had less warm ischemia time(WIT) (18∶20 mins, P=0.021), faster removed Jackson-Pratt drain (3.7∶4.3 days, P=0.022) and shorter hospital stay (5.8∶6.2 days, P=0.037) the interrupted, figure-of-eight suture group. There was a trend toward a better preserved GFR in the layered parenchymal suture group (eGFR decrease: 6.7∶8.9, P=0.045). But this effect did not reach statistical significance between the two groups for objective changes in the values on serum creatinine (P=0.797).Conclusions:The renorrhaphy technique of layered parenchymal suture is safe and feasible in retroperitoneal LPN. The evolving renorrhaphy technique will make the procedure faster and more readily that may decrease WIT and improve postoperative renal function.
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