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KMID : 0857020020170010041
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Kosin Medical Journal
2002 Volume.17 No. 1 p.41 ~ p.47
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Clinical Indications of Nephron Sparing Surgery
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Park Chul-Bo
Kang Ju-Seok
Lee Chang-Kyu
Rhew Hyun-Yul
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Abstract
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Background : The presenting study was undertaken to evaluate the efficacy of nephron sparing surgery in the management of benign renal lesion and renal cell carcinoma, with respect to the preservation of renal function and absence of tumor recurrence.
Methods : From 1985 to 1999, 35 patients underwent nephron sparing surgery for treatment. The clinical presentation, clinical diagnosis, surgical approach, outcome and complication in these patients were analyzed Surgical treatment for renal tumor was performed in a single, small (<4㎝). well localized, unilateral renal tumor with normal contralateral kidney except imperative case.
Results : The diagnosis of study population were composed of renal stone (5 cases), renal tuberculosis (3 cases), renal rupture (5 cases), double pelvis (2 cases), calyceal diverticulum (2 cases), partial hydronephrosis (3 cases) and renal tumor (15 cases). The postoperative biopsy results of renal tumors were renal cell carcinoma (7 cases), angiomyolipoma (5 cases), complicated cyst (2 cases), and renal pelvic cancer (1 cases). The surgical methods of nephron sparing procedure were chosen according to tumor location and surgeon’s preference. Partial nephrectomy was performed in 24, enucleation in 8 and wedge resection in 3. The case of renal pelvic cancer was metastatic cancer from contralateral kidney. The mean amount of intraoperative and postoperative bleeding was 430cc. The postoperative complications were observed in 4 cases (hematoma in 1, urinary fistula in 3 cases) and no nephrectomy due to complication was undergone. There was no change in postoperative renal function and no patient required acute hemodialysis following nephron sparing surgery. The overall mean postoperative follow-up in renal cell carcinoma was 39.4 (10-140) months. There was no evidence of local recurrence till this study was completed after nephron sparing surgery.
Conclusion : Nephron sparing surgery is a viable treatment option not only in benign renal lesion but also in localized small cell carcinoma.
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KEYWORD
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Nephron sparing surgery, Benign renal lesion, Renal cell carcinoma, Recurrence
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