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[Experience in nephron-sparing surgery in patients with small renal tumors]
Marvin Sánchez-Coral1, Jaime-Rodrigo Báez-Reyes1, Eugenio García-Cano2
1Servicio de Urología, Unidad Médica de Alta Especialidad, General Manuel Ávila Camacho, Instituto Mexicano del Seguro Social Puebla, Puebla, México.
Background:
Nephron -sparing surgery is currently the treatment of choice for surgical removal of solid renal tumours smaller than 7 cm, in the case of a solitary kidney, bilateral renal tumours or the presence of chronic renal failure.
Material And Methods:
An observational, descriptive, retrospective and cross-sectional study was conducted. The variables evaluated were: age at diagnosis, gender, intraoperative blood loss, operative time, preoperative tumour size, hospital stay, pathology report, pTNM classification, Fuhrman nuclear grade, pre- and post-operative creatinine, monitoring for cancer. All were analysed using SPSS v 22.
Results:
The study included 28 patients, 14 male and 14 women, with a mean age 52.3 years. The approach was lumbotomy in all patients. The mean hospital stay was 4.1 days. Mean perioperative bleeding loss was 380.3 ml. The mean preoperative creatinine was 0.96 mg/dl, with a post-operative mean of 1.12 mg/dl. Histopathology reported, 23 clear cell tumours, 2 angiomyolipomas, 2 oncocytomas, and 1 haemorrhagic cyst. Tumour staging was performed on 14 patients, with 13 patients T1bN0M0, and 1 patient T2aN0M0. In clear cell tumours, Fuhrman nuclear grade 2 was present in 16 patients and 7 patients were Fuhrman grade 3.
Conclusion:
Nephron sparing surgery is the choice procedure of choice in patients with small renal tumours, with good functional results without significant alteration in renal function. Outcome is optimal, with a low incidence of complications.
Insights
Nephron-sparing surgery effectively treats small renal tumors, preserving kidney function. This approach offers optimal outcomes with minimal complications for patients with solitary kidneys or chronic renal failure.
Area of Science:
- Urology
- Oncology
- Nephrology
Context:
- Nephron-sparing surgery is the standard for small renal tumors (<7cm).
- Indications include solitary kidneys, bilateral tumors, or chronic renal failure.
- This study evaluates outcomes of nephron-sparing surgery in such patients.
Purpose:
- To assess the efficacy and safety of nephron-sparing surgery for small renal tumors.
- To analyze perioperative outcomes and renal function post-surgery.
- To evaluate histopathological findings and cancer staging.
Summary:
- A retrospective study of 28 patients undergoing nephron-sparing surgery for renal tumors.
- Mean hospital stay was 4.1 days with average blood loss of 380.3 ml.
- Post-operative creatinine showed minimal increase, indicating preserved renal function. Histopathology revealed predominantly clear cell tumors.
Impact:
- Nephron-sparing surgery demonstrates good functional results with no significant renal function decline.
- The procedure is associated with optimal outcomes and a low complication rate.
- Supports nephron-sparing surgery as the preferred method for selected renal tumor cases.
