Cirugía laparoscópica oncológica renal en pacientes de 85 años o mayor edad

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2025-05-01 DOI:10.1016/j.acuro.2025.501688

P. Izquierdo , J. Huguet , A. Bravo-Balado , S. Fontanet , A. Farré , R. Sánchez , J.M. Gaya , Ó. Rodríguez-Faba , J. Palou , A. Breda

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引用次数: 0

Abstract

Objective

To analyze our series of radical nephrectomies and laparoscopic nephroureterectomies in elderly patients.

Materials and methods

A retrospective review of patients aged 85 years and older who underwent major laparoscopic surgery for renal tumors at our center between April 2005 and March 2022 was conducted. Clinical-pathological characteristics, complications, and postoperative outcomes were analyzed.

Results

Forty-seven patients were included, with a median age of 87 years. Fifteen nephrectomies for renal tumors (Group 1), and 32 nephroureterectomies for urinary tract tumors (Group 2) were performed. In Group 1, 4 postoperative complications were observed: 2 Clavien 1, one Clavien 2, and one Clavien 4a. The most common histology was clear cell carcinoma; 9 patients had locally advanced tumors (TNM ≥ T3) at diagnosis. Five-year cancer-specific survival and overall survival rates were 73% and 40%, respectively. In Group 2, 14 postoperative complications occurred: 6 (18.8%) Clavien 1, 4 (12.5%) Clavien 2, and 5 (15.6%) Clavien 5. All patients had urothelial carcinoma in their pathology reports. Twenty (62.5%) had invasive tumors (TNM ≥ T2) at diagnosis. Five-year cancer-specific survival and overall survival rates were 45% and 30%, respectively.

Conclusion

Laparoscopic renal oncologic surgery in elderly patients is feasible, although it is associated with a high morbimortality rate, particularly in those with urinary tract tumors. It is essential to provide this patient group with adequate information regarding the elevated surgical risks associated with the procedure.

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对85岁或85岁以上患者进行肾肿瘤腹腔镜手术

目的分析我院系列根治性肾切除术和腹腔镜肾输尿管切除术在老年患者中的应用。材料与方法回顾性分析2005年4月至2022年3月在我中心行大腹腔镜肾肿瘤手术的85岁及以上患者。分析临床病理特征、并发症及术后结果。结果纳入47例患者，中位年龄87岁。1组15例肾肿瘤切除术，2组32例尿路肿瘤肾输尿管切除术。1组术后并发症4例：Clavien 1 2例，Clavien 2 1例，Clavien 4a 1例。最常见的组织学为透明细胞癌；9例确诊为局部晚期肿瘤（TNM≥T3）。5年癌症特异性生存率和总生存率分别为73%和40%。2组术后并发症14例，Clavien 1 6例（18.8%），Clavien 2 4例（12.5%），Clavien 5 5例（15.6%）。所有患者病理报告均为尿路上皮癌。诊断时有浸润性肿瘤（TNM≥T2） 20例（62.5%）。5年癌症特异性生存率和总生存率分别为45%和30%。结论腹腔镜肾肿瘤手术在老年患者中是可行的，但其死亡率较高，特别是尿路肿瘤患者。向这组患者提供与手术相关的手术风险升高的充分信息是至关重要的。

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来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.