Abstract：Objective:To evaluate the feasibility of retroperitoneal laparoendoscopic partial nephrectomy(RLPN) for renal tumors ≥7 cm.Methods:A retrospective analysis of 28 patients with renal tumors ≥7 cm in whom RLPN was performed between June 2008 and March 2012. Eight patients were males, and 20 patients were females. The age ranged from 19-69 years (mean 40 years), the body mass index 18.7-31.2 kg/m2 (mean 23.6 kg/m2), and the American Society of Anesthesiologists score 1-2. Fourteen cases were on both sides. There were no adjacent organ infiltration, lymph node metastases or distant metastasis found on preoperative examinations.Results:All procedures were technically successful without open conversion. The operative time was 70-205 mins (mean 115 mins) with blood loss of 10-350 ml (mean 50 ml), and warm ischemia time was 0-46 mins (mean 23 mins). All patients resumed ambulation on postoperative 3 to 9 days (mean 5.5 days). The length of drain stay was 2-13 days (mean 5 days), and the mean drainage volume was 195 ml. The length of hospital stay after operation was 7-16 days (mean 8 days). Tumor diameter was 7-16 cm (mean 8 cm). Twenty-five were angiomyolipoma, 1 was lipoma, 1 was papillary renal cell carcinoma (type 1), and 1 was multilocular clear cell renal cell carcinoma. The patients were followed up for 7-52 months (mean 34.5 months), during which time renal function was normal without local or systemic progression.Conclusions:With prudent selection of patients, RLPN is safe and feasible for renal tumors ≥7 cm. Massive cases and long-term follow up are required to further assess the appropriateness and potential of this technique.
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