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Changing trends in partial nephrectomy at Walter Reed Army Medical Center.

A Rosin1, J J Bauer, S J Swanson

  • 1Metropolitan Hospital Center, Department of Emergency Medicine, New York, NY 10029, USA.

Military Medicine
|May 24, 2001
PubMed
Summary
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Partial nephrectomy trends shifted from benign disease to renal masses, with increased use for incidentally discovered tumors. The procedure shows comparable curative ability to radical nephrectomy for cancer.

Area of Science:

  • Urology
  • Surgical Oncology
  • Nephrology

Background:

  • Partial nephrectomy (PN) is a nephron-sparing surgical technique.
  • Historical trends in PN indications and outcomes are crucial for understanding evolving surgical practices.

Purpose of the Study:

  • To evaluate changes in indications, frequency, complications, and outcomes of partial nephrectomy over a 25-year period.
  • To analyze trends in nephron-sparing surgery for benign versus malignant renal disease.

Main Methods:

  • Retrospective chart review of 309 patients undergoing partial nephrectomy from 1970-1995.
  • Detailed analysis of 47 patient records from 1986-1996, focusing on indications, complications, and outcomes.

Main Results:

Related Experiment Videos

  • A decline in PN for benign disease contrasted with an increase for renal cell carcinoma (RCC).
  • Fifty-seven percent of PNs (1986-1996) were for incidentally discovered renal tumors.
  • Complication rate was 25%, with acute renal insufficiency in 4.5%. Cancer-specific 5-year survival for RCC was 88.1%.

    • Conclusions:

    • Nephron-sparing surgery trends shifted towards treating renal masses rather than benign conditions.
    • Partial nephrectomy demonstrates comparable curative potential to radical nephrectomy for renal cell carcinoma.
    • PN is increasingly utilized for incidentally detected renal tumors, highlighting advancements in diagnostic imaging and surgical management.