Related Experiment Video
Updated: May 21, 2026
5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
Published on: April 4, 2025
Clinical, pathologic, and functional outcomes after nephron-sparing surgery in patients with a solitary kidney: a
Adam C Mues1, Ruslan Korets, Joseph A Graversen
1New York University School of Medicine, New York, NY, USA.
Background And Purpose:
Surgical management of a renal neoplasm in a solitary kidney is a balance between oncologic control and preservation of renal function. We analyzed patients with a renal mass in a solitary kidney undergoing nephron-sparing procedures to determine perioperative, oncologic, and renal functional outcomes.
Patients And Methods:
A multicenter study was performed from 12 institutions. All patients with a functional or anatomic solitary kidney who underwent nephron-sparing surgery for one or more renal masses were included. Tumor size, complications, and recurrence rates were recorded. Renal function was assessed with serum creatinine level and estimated glomerular filtration rate.
Results:
Ninety-eight patients underwent 105 ablations, and 100 patients underwent partial nephrectomy (PN). Preoperative estimated glomerular filtration rate (eGFR) was similar between the groups. Tumors managed with PN were significantly larger than those managed with ablation (P<0.001). Ablations were associated with a lower overall complication rate (9.5% vs 24%, P=0.01) and higher local recurrence rate (6.7% vs 3%, P=0.04). Eighty-four patients had a preoperative eGFR ≥60 mL/min/1.73 m(2). Among these patients, 19 (23%) fell below this threshold after 3 months and 15 (18%) at 12 months. Postoperatively, there was no significant difference in eGFR between the groups.
Conclusions:
Extirpation and ablation are both reasonable options for treatment. Ablation is more minimally invasive, albeit with higher recurrence rates compared with PN. Postoperative renal function is similar in both groups and is not affected by surgical approach.
Insights
Nephron-sparing surgery for kidney tumors in a solitary kidney offers comparable renal function outcomes whether using ablation or partial nephrectomy (PN). Ablation has fewer complications but higher recurrence rates than PN.
Area of Science:
- Urology
- Nephrology
- Surgical Oncology
Background:
- Managing renal neoplasms in solitary kidneys requires balancing cancer control with kidney function preservation.
- Nephron-sparing surgery is crucial for patients with a solitary kidney.
Purpose of the Study:
- To evaluate perioperative, oncologic, and renal functional outcomes of nephron-sparing procedures for renal masses in solitary kidneys.
- Compare outcomes between ablation and partial nephrectomy (PN).
Main Methods:
- A multicenter study included patients with a solitary kidney undergoing nephron-sparing surgery for renal masses.
- Data collected included tumor size, complications, recurrence rates, serum creatinine, and estimated glomerular filtration rate (eGFR).
Main Results:
- Partial nephrectomy (PN) managed larger tumors than ablation. Ablation had lower complication rates (9.5% vs 24%) but higher local recurrence (6.7% vs 3%).
- Postoperative eGFR was similar between ablation and PN groups.
- A significant percentage of patients experienced a decline in eGFR postoperatively, regardless of the surgical approach.
Conclusions:
- Both ablation and PN are viable options for treating renal masses in solitary kidneys.
- Ablation is less invasive but associated with increased recurrence rates compared to PN.
- Surgical approach does not significantly impact postoperative renal function.
Related Concept Videos
01:26Kidney Transplant II: Surgical Procedure
01:28Kidney Transplant I: Introduction
01:16Kidney Transplant III: Nursing Management
01:10Nephrons
01:29Acute Kidney Injury III: Clinical Manifestations