Nephron sparing surgery [partial nephrectomy] for small, localized renal tumors

ABSTRACT

Is nephron sparing surgery [partial nephrectomy] effective for small, localized renal cell carcinoma with durable long-term success? We present our results of partial nephrectomy for small localized renal tumors in a group of patients treated and followed up during the last 6 years at the Urology Department, Zagazig University Hospitals. Patients and .During the period between October 1995 and March 2001, nephron-sparing surgery [partial nephrectomy] was performed in 13 patients with small localized and peripherally located renal tumors. Patients were 10 men and 3 women and their ages ranged from 33 to 72 years [mean 50 years]. The patients were followed postoperatively by abdominal ultrasound, abdominal CT and chest X-ray every 3 to 6 months. The mean follow up interval was 27 months [range 6-65]. The histopathology revealed renal oncocytoma in one patient and renal angiomyolipoma in one patient. In the remaining 11 patients, the histopathology revealed renal cell carcinoma and the tumor stages were Tl in 5 patients T2 in 4 patients and T3a in 2 patients. Postoperative complications included, retroperitoneal hematoma which was managed conservatively in 2 patients and prolonged. Urine leakage from the wound which resolved after placement of double J-ureteral stent in 3 patients. After a mean follow up interval of 27 months [range 6-65], two patients developed local tumor recurrence and two patients developed metastatic renal cell carcinoma. The remaining 7 patients [with small localized renal cell carcinoina treated by partial nephrectomy] were free of disease and had no evidence of recurrence.Nephron sparing surgery [partial nephrectomy] is effective for small, localized and peripherally located renal cell carcinoma. It gives long-term tumor control with preservation of renal function, and the overall prognosis depends on the initial pathological tumor stage. Also benign tumors may be diagnosed and removed without loss of the kidney