KẾT QUẢ PHẪU THUẬT NỘI SOI SAU PHÚC MẠC CẮT THẬN BÁN PHẦN ĐIỀU TRỊ U THẬN TẠI BỆNH VIỆN BẠCH MAI

Abstract

Objectives: To evaluate the clinical, subclinical characteristics, and surgical outcomes of retroperitoneal laparoscopic partial nephrectomy (RLPN) for renal tumors at Bach Mai Hospital, while exploring several prognostic factors related to the procedure. Participants and

Methods: A descriptive, cross-sectional, retrospective study was conducted on 26 patients diagnosed with T1a and T1b (N0M0) renal tumors who underwent RLPN at the Department of Urology, Bach Mai Hospital, from November 2022 to March 2025.

Results: The mean age of the patients was 55.2 ± 14.5 years, and 77% of tumors were detected incidentally. The average tumor size was 28.4 ± 10 mm, with a mean RENAL nephrometry score of 5.42 ± 1.3, indicating mostly low-complexity masses. Intraoperatively, the mean operative time was 124 ± 31 minutes, and the mean warm ischemia time (WIT) was 23.7 ± 6.1 minutes. Estimated blood loss was 96 ± 67 ml. Postoperative complications occurred in 27% of patients, including two cases (7.7%) of renal artery pseudoaneurysm successfully managed by selective angioembolization. Histopathology confirmed malignancy in 80.8% of cases, with clear cell renal cell carcinoma (ccRCC) being the most common subtype (62%). All tested surgical margins were negative. A statistically significant correlation was found between higher RENAL scores and blood loss exceeding 150 ml (p = 0.042). Over a mean follow-up period of 20.6 ± 8 months, no tumor recurrence or progression was observed.

Conclusion: Retroperitoneal laparoscopic partial nephrectomy is a safe and effective approach for early-stage renal tumors, providing reliable oncological control and maximal preservation of renal function.