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Outcome of nephron-sparing surgery: elective versus imperative indications
Ali Riza Kural1, Oktay Demirkesen, Bulent Onal
1Department of Urology, University of Istanbul, Cerrahpasa School of Medicine, Istanbul, Turkey. kural@superonline.com
Urologia Internationalis
|August 2, 2003
Summary
Nephron-sparing surgery (NSS) is effective for early-stage renal tumors, preventing unnecessary kidney removal. Elective NSS shows better outcomes than imperative NSS, with high survival rates and preserved kidney function.
Area of Science:
- Urology
- Nephrology
- Oncology
Background:
- Increasing incidental detection of early-stage renal tumors fuels interest in nephron-sparing surgery (NSS).
- NSS aims to preserve renal parenchyma while removing tumors.
Purpose of the Study:
- To compare outcomes of NSS based on elective versus imperative indications.
- To evaluate surgical techniques, complications, and oncological results of NSS.
Main Methods:
- Retrospective analysis of 76 patients undergoing NSS between 1988 and 2001.
- Patients were divided into elective (Group I, n=50) and imperative (Group II, n=26) indication groups.
- Comparison of surgical parameters, pathology, complications, and disease-free status.
Main Results:
- Tumors were incidentally detected in 63% of patients.
- Partial nephrectomy was more common in the elective group (90% vs. 69%).
- Complication rates were significantly higher in the imperative group (p=0.000).
- No local recurrence or distant metastases were detected in 56 patients with a mean follow-up of 37.1 months.
- Overall and cancer-specific survival rates were 94% and 98% for the entire cohort.
Conclusions:
- NSS is a reliable treatment for low-stage renal tumors, avoiding unnecessary nephrectomies for benign lesions.
- Elective NSS demonstrates superior outcomes compared to imperative NSS.
- Preservation of renal function was observed, with stable serum creatinine levels post-surgery.