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MINERVA UROLOGICA E NEFROLOGICA

A Journal on Nephrology and Urology


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Minerva Urologica e Nefrologica 2004 September;56(3):319-24

language: Italian

Nephron sparing surgery

Salciccia S., Cirocchi R., Salciccia P.

Unità Operativa di Urologia ASL 2, Urbino


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Aim. The ­role of neph­ron spar­ing sur­gery in ­patients ­with a sol­i­tary kid­ney, bilat­er­al kid­ney ­tumors or an ­impaired ­renal func­tion has ­been wide­ly accept­ed. Par­tial neph­rec­to­my in ­patients ­with a nor­mal con­tra­lat­er­al kid­ney is ­still ­under dis­cus­sion.
Meth­ods. We eval­u­at­ed the effec­tive­ness and safe­ty of the neph­ronspar­ing sur­gery in the treat­ment of low ­stage ­renal ­cell car­ci­no­ma ver­sus rad­i­cal neph­rec­to­my. We eval­u­at­ed the ­records of 12 ­patients ­with local­ized, symp­tom­less ­small ­renal mass­es (<4 cm) treat­ed ­with neph­ronspar­ing sur­gery (­group A) and 12 ­patients ­matched for age, ­tumor loca­tion, ­size, and ­stage who ­were treat­ed ­with rad­i­cal neph­rec­to­my (­group B).
­Results. The oper­a­tions ­were suc­cess­ful­ly com­plet­ed in all intend­ed cas­es. No ­major bleed­ing or ­urine leak­age ­from the enu­clea­tion bed was ­observed. ­None of the cas­es pre­sent­ed ­with post­op­er­a­tive bleed­ing or ­urine leak­age ­from the enu­clea­tion bed. ­Severe impair­ment of the ­renal func­tion was not ­observed in any ­case eval­u­at­ed by ­means of ser­um crea­ti­nine and crea­ti­nine clear­ance. The over­all sur­vi­val ­rate was 100% with­out recur­rence up to 24 ­months of the ­mean fol­low-up.
Con­clu­sion. Par­tial neph­rec­to­my for ­small periph­er­al ­lesions is a ­safe pro­ce­dure ­with low mor­bid­ity. No def­i­nite recur­renc­es are evi­dent at an ear­ly ­stage of fol­low-up, ­although long­er ­review (prob­ably ­more ­than 10 ­years) ­will be ­required to ­assess can­cer-spe­cif­ic sur­vi­val fol­low­ing ­this pro­ce­dure.

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