RESUMO
OBJECTIVES: We reviewed the feasibility and safety of nephron sparing surgery for renal cell carcinoma in patients with von Hippel Lindau (VHL) disease. METHODS: We selected 22 patients with (VHL) disease with a mean age of 43 (range 30-56), from whom 16 underwent radical nephrectomy or nephron sparing surgery at our department between 2000 and 2015. RESULTS: A total of 33 tumors were treated, by either tumorectomy (n=20), partial nephrectomy (n=5), percutaneous renal radiofrequency ablation (n=3) edaor radical nephrectomy (n=5). All procedures were successfully completed without intraoperative and postoperative complications. The diameter of the tumor ranged from 2.8 to 4.8 cm. The interval between treatments in patients operated more than once was 40 months. Renal function stayed stable with basal creatinine and current creatinine 0.74 ± 0.21 mg/dl and 0.93 ± 0.22 mg/dl respectively. Median follow-up was 72.3 months. Cancer-specific survival was 97%. CONCLUSIONS: nephron sparing surgery in renal tumors >3 cm is an effective and safe treatment for VHL patients.
Assuntos
Carcinoma de Células Renais/cirurgia , Neoplasias Renais/cirurgia , Nefrectomia/métodos , Tratamentos com Preservação do Órgão , Adulto , Carcinoma de Células Renais/complicações , Feminino , Humanos , Neoplasias Renais/complicações , Masculino , Pessoa de Meia-Idade , Néfrons , Doença de von Hippel-Lindau/complicaçõesRESUMO
OBJETIVOS: Evaluar la incidencia y el manejo de la afectación renal mediante la cirugía conservadora de nefronas en pacientes con la enfermedad de von Hippel-Lindau (eVHL). MÉTODOS: Hemos seleccionado a 22 pacientes con eVHL, con una edad media de 43 años (rango 30-56), de los cuales 16 fueron sometidos a nefrectomía radical o cirugía conservadora de nefronas en nuestro departamento entre los años 2000 y 2015. RESULTADOS: Un total de 33 tumores fueron tratados, bien mediante tumorectomía (n=20), nefrectomía parcial (n=5), ablación por radiofrecuencia vía percutánea (n=3) o nefrectomía radical (n=5). Todos los procedimientos fueron completados con éxito, sin complicación intraoperatoria ni postoperatoria. El diámetro del tumor osciló entre 2,8 y 4,8 cm. El intervalo entre tratamientos en pacientes operados más de una vez fue de 40 meses. La función renal se mantuvo estable con creatinina basal y actual de 0,74+/-0,21 mg/dl y 0,93+/-0,22 mg/dl respectivamente. La media de seguimiento fue de 72,3 meses. La supervivencia cáncer específica fue de 97%. CONCLUSIONES: La coordinación multidisciplinaria es esencial en el manejo de la eVHL. La vigilancia activa en tumores <3 cm y el tratamiento posterior mediante la cirugía conservadora de nefronas permite preservar la función renal de manera segura
OBJECTIVES: We reviewed the feasibility and safety of nephron sparing surgery for renal cell carcinoma in patients with von Hippel Lindau (VHL) disease. METHODS: We selected 22 patients with (VHL) disease with a mean age of 43 (range 30-56), from whom 16 underwent radical nephrectomy or nephron sparing surgery at our department between 2000 and 2015. RESULTS: A total of 33 tumors were treated, by either tumorectomy (n=20), partial nephrectomy (n=5), percutaneous renal radiofrequency ablation (n=3) or radical nephrectomy (n=5). All procedures were successfully completed without intraoperative and postoperative complications. The diameter of the tumor ranged from 2.8 to 4.8 cm. The interval between treatments in patients operated more than once was 40 months. Renal function stayed stable with basal creatinine and current creatinine 0.74 ± 0.21 mg/dlm and 0.93 ± 0.22 mg/dl respectively. Median follow-up was 72.3 months. Cancer-specific survival was 97%. CONCLUSIONS: nephron sparing surgery in renal tumors >3 cm is an effective and safe treatment for VHL patients
