Nephron-sparing surgery: a call for greater application of established techniques.

Abstract:

OBJECTIVES:To examine the results of open partial nephrectomy (OPN) over a 15-year period in a large UK teaching hospital and to compare results with other series including minimally invasive techniques, as nephron-sparing techniques are still under-utilized in the surgical treatment of renal carcinoma. A standardized technique is described that we think minimizes the risk of postoperative urinoma. PATIENTS AND METHODS:We retrospectively reviewed a series of 141 patients who underwent OPN performed over a 15-year period in one centre by the senior author (D.M.A.W.). A notable feature of this series compared with others is the high proportion of patients undergoing other major synchronous surgery. RESULTS:In all, 141 patients underwent 147 OPNs, with six undergoing bilateral procedures, of which 82 were for imperative indications (single kidney, bilateral synchronous tumours, or pre-existing renal impairment). There were three perioperative deaths, two in patients undergoing other synchronous major surgery. In all, 38 patients had postoperative complications: 28 patients required blood transfusion (four required intervention for their bleeding), five required acute dialysis and three late dialysis. There was a 90% cancer-specific survival rate at a median follow-up of 2 years. CONCLUSIONS:This series confirms the trend towards improved outcomes and decreased complications in OPN at a time when its place is challenged by minimally invasive techniques.

journal_name

BJU Int

journal_title

BJU international

authors

Young JG,Luscombe CJ,Lynch C,Wallace DM

doi

10.1111/j.1464-410X.2008.07829.x

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

1389-93

issue

10

eissn

1464-4096

issn

1464-410X

pii

BJU7829

journal_volume

102

pub_type

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