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Original Research

Open nephron-sparing treatment of T1 renal masses: Surgical, oncologic and functional outcomes


1 Atatürk Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı, Erzurum

2 Akçaabat Haçkalıbaba Devlet Hastanesi Üroloji Kliniği, Trabzon


DOI :
New J Urol. 2013; 8 (3): 54-58

Abstract

Objective: We aimed to present surgical, onco-logical, and functional outcomes. We aimed to pre-sent surgical, oncological and functional outcomes of patients with T1 stage renal tumour which were trea-ted with nephron-sparing surgery.

Materials and Methods: A total of 36 patients who had undergone nephron-sparing surgery (NSS) between 2004, and 2012 for the management of  pre-viously identified renal masses of < 7 cm were inc-luded in our study. Demographic data, radiological, and histopathological characteristics of the cases, and the follow-up periods were retrospectively evaluated. During postoperative follow-up period whole abdo-men was scanned with magnetic resonance imaging technique so as to evaluate local recurrences.

Results: We performed retroperitoneal NSS using open technique on a total of 36 patients (19 women, and 17 men) with a median age of 54 years (range, 23-88 yrs). Mean diameter  of  the tumours was detected to be 2.9x2.5 cm. Three (8 %) patients had bilateral renal masses. Warm ischemia had been  used intraoperatively for 2 patients, and for the rema-ining patients this procedure was achieved without ischemia.   Median pre- and postoperative creatinine values were 0.87, and  0.96 mg/dl, respectively. Incre-ase in postoperative creatinine values were not found to be statistically significant ( p=0.81). Any increase in postoperative creatinine values was not observed in  2 patients who had been operated under warm ischemia. Median follow-up period was 39 months (8-92 mos) . Local recurrence or distant metastasis was not observed in any patient. Disease –specific, and overall survival rates were similar, and detected as 100 percent.

Conclusion: Currently, open partial nephrec-tomy is the most frequently  employed method of nephron-sparing surgery. It retains its place as a sa-fely performed modality to be used in the manage-ment of renal tumours with proper indications, and oncological results similar to those of radical neph-rectomy, but lesser risk of development of chronic re-nal disease.

Key Words: Nephron sparing surgery, Renal


Abstract

Objective: We aimed to present surgical, onco-logical, and functional outcomes. We aimed to pre-sent surgical, oncological and functional outcomes of patients with T1 stage renal tumour which were trea-ted with nephron-sparing surgery.

Materials and Methods: A total of 36 patients who had undergone nephron-sparing surgery (NSS) between 2004, and 2012 for the management of  pre-viously identified renal masses of < 7 cm were inc-luded in our study. Demographic data, radiological, and histopathological characteristics of the cases, and the follow-up periods were retrospectively evaluated. During postoperative follow-up period whole abdo-men was scanned with magnetic resonance imaging technique so as to evaluate local recurrences.

Results: We performed retroperitoneal NSS using open technique on a total of 36 patients (19 women, and 17 men) with a median age of 54 years (range, 23-88 yrs). Mean diameter  of  the tumours was detected to be 2.9x2.5 cm. Three (8 %) patients had bilateral renal masses. Warm ischemia had been  used intraoperatively for 2 patients, and for the rema-ining patients this procedure was achieved without ischemia.   Median pre- and postoperative creatinine values were 0.87, and  0.96 mg/dl, respectively. Incre-ase in postoperative creatinine values were not found to be statistically significant ( p=0.81). Any increase in postoperative creatinine values was not observed in  2 patients who had been operated under warm ischemia. Median follow-up period was 39 months (8-92 mos) . Local recurrence or distant metastasis was not observed in any patient. Disease –specific, and overall survival rates were similar, and detected as 100 percent.

Conclusion: Currently, open partial nephrec-tomy is the most frequently  employed method of nephron-sparing surgery. It retains its place as a sa-fely performed modality to be used in the manage-ment of renal tumours with proper indications, and oncological results similar to those of radical neph-rectomy, but lesser risk of development of chronic re-nal disease.

Key Words: Nephron sparing surgery, Renal