Clampless laparoendoscopic single-site partial nephrectomy for renal cancer with low PADUA Score: technique and surgical outcomes.

==inizio abstract==

Objective: To describe the technique and report the surgical outcomes of clampless LESS partial nephrectomy (LESS-PN) in the treatment of renal cell carcinoma with low PADUA-score.
Methods and Results: Clampless LESS-PN was performed in 14 patients with cT1a renal tumors. The indications to perform a clampless LESS-PN was represented by low risk, laterally based renal tumors, located away from the renal hilum and with a PADUA score ≤ 7.
Demographic data and perioperative and postoperative variables were recorded and analysed. The function of the kidney was evaluated by measuring serum creatinine and estimated glomerular filtration rate (eGFR) pre- and postoperatively and at 6-month follow up.
The median operative time was 120 min and ischemia time was zero in all cases. Only one early complication was recorded: one patient developed a flank haematoma which could be treated by conservative therapy (Clavien Grade 1).
In terms of renal function, serum creatinine and MDRD eGFR did not present statistical significant different in the different moments of measurement.
The definitive pathologic results revealed 12 pT1a- renal cell carcinomas and 2 pT1a-chromophobe renal carcinomas were reported. All tumors were removed with negative surgical margins.
All patients were enthusiastic with the appearance of the scars.
At a median follow-up period of 12 months (range 8-15 months), all patients were alive without evidence of tumor recurrence or port-site metastasis.
Conclusions: Clampless LESS-PN is a safe and feasible surgical procedure in the treatment of low risk T1a renal cell carcinoma, with excellent cosmetic results.

==fine abstract==