Laparoscopic Partial Nephrectomy vs. Open Partial Nephrectomy Early Milestone: Epigrams from Sudan

Background: Partial nephrectomy is recognized as the gold standard treatment for localized renal cell carcinoma (RCC). While open partial nephrectomy has long been a conventional approach, the advent of laparoscopic surgical techniques has led numerous institutions worldwide to adopt laparoscopic partial nephrectomy (LPN) as the preferred method. Although comparative studies have evaluated these two surgical modalities, conclusive recommendations favoring one technique over the other remain elusive. The objective of this investigation was to assess the oncological outcomes associated with laparoscopic versus open partial nephrectomy. Methodology: This study encompassed a cohort of 38 patients who underwent laparoscopic partial nephrectomy (11 patients) or open partial nephrectomy (27 patients) at the Kuwaiti Specialized Hospital in Khartoum, Sudan between 2020 and 2023. A meticulous review of patient records was conducted, encompassing preoperative data, intraoperative parameters, and postoperative follow-up information. Statistical analyses were performed using SPSS software version 26. Results: The study comprised 38 patients, with 11 in the laparoscopic group and 27 in the open group. The mean age of participants was 57.6 years (±16). No significant differences were noted in the baseline characteristics or clinical presentations of the two cohorts. However, the laparoscopic group exhibited a longer operative time (p = 0.005) and ischemia time (p = 0.03). Additionally, no notable differences were observed in estimated blood loss (p = 0.224), surgical margin status (p = 0.35), or rates of local recurrence (p = 0.5). Neither group experienced portsite recurrence, and no patients presented with distant metastasis. Furthermore, there were no significant changes in serum creatinine levels or estimated glomerular filtration rates in either group (p = 0.4 and p = 0.15, respectively). Conclusion: Laparoscopic partial nephrectomy demonstrates oncological outcomes that are comparable to those of open partial nephrectomy, with no significant differences in surgical margin status, local recurrence, or distant metastasis. This approach is deemed safe and exhibits advantages such as reduced invasiveness, diminished postoperative pain, and expedited recovery to normal activities, rendering it a viable treatment option even in low-income settings. Nonetheless, open partial nephrectomy remains the preferred choice in circumstances where laparoscopic techniques are not feasible or when adequate surgical expertise is lacking.