[Nephron sparing surgery]

The role of nephron sparing surgery in patients with a solitary kidney, bilateral kidney tumors or an impaired renal function has been widely accepted. Partial nephrectomy in patients with a normal contralateral kidney is still under discussion.

We evaluated the effectiveness and safety of the nephronsparing surgery in the treatment of low stage renal cell carcinoma versus radical nephrectomy. We evaluated the records of 12 patients with localized, symptomless small renal masses (<4 cm) treated with nephronsparing surgery (group A) and 12 patients matched for age, tumor location, size, and stage who were treated with radical nephrectomy (group B).

The operations were successfully completed in all intended cases. No major bleeding or urine leakage from the enucleation bed was observed. None of the cases presented with postoperative bleeding or urine leakage from the enucleation bed. Severe impairment of the renal function was not observed in any case evaluated by means of serum creatinine and creatinine clearance. The overall survival rate was 100% without recurrence up to 24 months of the mean follow-up.

Partial nephrectomy for small peripheral lesions is a safe procedure with low morbidity. No definite recurrences are evident at an early stage of follow-up, although longer review (probably more than 10 years) will be required to assess cancer-specific survival following this procedure.