Elective open nephron-sparing surgery for renal masses: single-center experience with 129 consecutive patients.

Abstract:

OBJECTIVES:To present our experience with elective, open, nephron-sparing surgery for renal masses in a contemporary, consecutive series. METHODS:In this retrospective study, the files of all patients who underwent elective nephron-sparing surgery between January 1996 and December 2002 at our institution were reviewed. The preoperative workup included renal ultrasonography and abdominal computed tomography. The histologic findings, complications, and oncologic outcome were studied. The surgical technique (ischemia and regional hypothermia) was identical in all patients. RESULTS:A total of 129 patients (mean age 61 years) were analyzed. The mean +/- standard deviation tumor size on preoperative computed tomography was 4.0 +/- 2.4 cm. Renal cell carcinoma was present in 86 patients (66.7%), a benign cyst in 18 (13.9%), oncocytoma in 10 (7.8%), angiomyolipoma in 7 (5.5%), adenoma in 4 (3.1%), xanthogranulomatous pyelonephritis in 3 (2.3%), and metastasis of a malignant melanoma in 1 patient. Two patients (1.6%) required secondary nephrectomy because of postoperative bleeding. After a median follow-up of 34 months (range 2 to 91), no patient had developed local recurrence, one (0.8%) had developed lymph node metastasis, and two (1.6%) had developed distant metastases. The creatinine clearance decreased from 77 +/- 27 mL/min before surgery to 64 +/- 23 mL/min after a median of 34 months. CONCLUSIONS:The results of this contemporary, monocenter experience underline the role of open, elective, nephron-sparing surgery for patients with small renal masses, particularly because benign histologic findings were present in almost one third of patients.

journal_name

Urology

journal_title

Urology

authors

Marszalek M,Ponholzer A,Brössner C,Wachter J,Maier U,Madersbacher S

doi

10.1016/j.urology.2004.02.007

subject

Has Abstract

pub_date

2004-07-01 00:00:00

pages

38-42

issue

1

eissn

0090-4295

issn

1527-9995

pii

S0090429504002225

journal_volume

64

pub_type

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