Single-layer versus double-layer suture during laparoscopic partial nephrectomy for renal tumours in close proximity to the collecting system or renal sinus: A propensity-matched analysis.

OBJECTIVES

To compares perioperative outcomes of single-layer suture (SLS) and double-layer suture (DLS) technique for laparoscopic partial nephrectomy (LPN) in patients with renal tumours in close proximity to the collecting system or renal sinus.

PATIENTS AND

METHODS

A total of 178 patients with renal tumours adjacent to the collecting system or renal sinus were identified from the databases of our institution who underwent LPN between November 2020 and December 2023. SLS (n = 79) or DLS (n = 99) technique was used for renal defect suture. Propensity score matching was performed to minimize selection bias. Propensity scores were calculated for age, sex, body mass index, tumour diameter, renal nephrometry score, history of diabetes or hypertension, preoperative haemoglobin and preoperative estimated glomerular filtration rate (eGFR). Perioperative data were analysed.

RESULTS

In all, 76 patients could be matched in each group. Compared with DLS, SLS significantly reduced the warm ischaemia time (22.45 ± 7.75 vs. 28.87 ± 7.77 min, p < 0.001). There was no difference between the two groups for postoperative complications including transfusion-treated blood loss (1.3% vs. 1.3%, p = 1.000). No grade III-V complications occurred. Moreover, no significant difference was found in postoperative haemoglobin decline between the two groups (1.27 ± 1.20 vs. 1.40 ± 1.20 g/dL, p = 0.508).

CONCLUSION

SLS during LPN offers effective renorrhaphy, reducing the warm ischaemia time without increasing the risk of complications.