THE OUTCOMES OF ONE YEAR FOLLOW UP OF LAPAROSCOPIC PARTIAL NEPHRECTOMY

Background: Partial nephrectomy involves the complete removal of the tumor while ideally preserving the function of the normal kidney tissue. This operation offers several advantages over radical nephrectomy; including improved overall survival rates and a reduced risk of cardiovascular death. Objectives: To determine the outcomes after laparoscopic partial nephrectomy with respect to changes in kidney function, local recurrence and distant cancer metastasis. Methods: This is an interventional study. It was conducted at Al-Kadhimiya Teaching Hospital in Al-Karkh, Baghdad, from June 1, 2024, to November 30, 2025. The study included 20 patients with renal tumors who underwent laparoscopic partial nephrectomy with one year of follow-up. The questionnaire consisted of five sections. The first section covered the patients' demographics. The second section covered preoperative patient characteristics. The third section covered hospital and surgical information. The fourth section covered postoperative information at the time of discharge. The fifth section covered postoperative follow-up visits at the first, third, sixth, and twelfth months. Results: Among the study participants, 12 (60%) patients were males and 8 (40%) patients were females, with male to female ratio of 1.5:1. The mean ± standard deviation age of the study patients was 58.1 ± 13.98 years, while the mean ± standard deviation BMI of the study patients was 29.13 ± 3.98. Statistically significant difference between males and females regarding their mean age (P value = 0.023). while no statistically significant difference found between them regarding their mean BMI (P value = 0.592). The study found that 7 (35%) patients had hypertension, followed by diabetes in 3 (15%) patients. While 1 (5%) patient suffer from duodenal ulcer. The median operation time was 2.75 hours. The median hospital stays of the study patients was 1 (1-2) day. Only 1 patient reported operative complication that was ureteric injury which was repaired by surgical suturing over stent. Four patients had a grade I rating after surgery, while only one patient had a grade II rating according to the Clavien-Dindo classification of surgical complications. Follow up visits showed that the means of serum creatinine gradually increased, while the means of estimated glomerular filtration rate seem to be slightly decreased over the study time interval. At one year follow-up, 18 patients (90%) had no evidence of local recurrence or distant other organ metastasis, while two patients one patient was diagnosed with local recurrence at the 6th month visit and another one diagnosed with distant metastasis at the 12th month of follow up visit. All of the patients stay alive but 2 of them alive with the cancer at the 12th month. Conclusions: Patients treated by partial nephrectomy had excellent overall survival rate after one year of the operation. Patients treated by this operation have mild decrease in their estimated glomerular filtration rate and mild increase in their serum creatinine level.