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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
Published on: July 3, 2013
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[Nephron sparing surgery in complex kidney tumors]
S A Rakul1, K V Pozdnyakov1, R A Eloev1
1Saint Petersburg City Clinical Hospital No 40, Saint Petersburg, Russia.
Urologiia (Moscow, Russia : 1999)
|December 30, 2020
Summary
Nephron sparing surgery (NSS) effectively treats complex kidney tumors (R.E.N.A.L. 10-12) with acceptable complications. This approach offers a viable alternative to radical nephrectomy, preserving kidney function with a low positive surgical margin rate.
Area of Science:
- Urology
- Oncology
- Nephrology
Background:
- Complex and large kidney tumors pose a surgical challenge.
- Nephron sparing surgery (NSS) is an alternative to radical nephrectomy.
- The R.E.N.A.L. nephrometry score stratifies tumor complexity.
Purpose of the Study:
- To evaluate the outcomes of NSS for complex and large kidney tumors (R.E.N.A.L. score 10-12).
- To assess postoperative complications and changes in estimated glomerular filtration rate (eGFR).
Main Methods:
- Retrospective analysis of 361 kidney neoplasm interventions (2013-2018).
- Focus on 44 patients with R.E.N.A.L. scores of 10-12 undergoing NSS.
- Complications classified using Clavien-Dindo system; eGFR assessed pre- and post-operatively.
Main Results:
- Robot-assisted partial nephrectomy was the predominant approach (95%).
- Postoperative complications occurred in 22.73% of cases (Grade III in 15.91%).
- A positive surgical margin was rare (2.27%); eGFR declined moderately (average 6.01%).
Conclusions:
- NSS is an effective treatment for complex renal tumors, comparable to radical nephrectomy.
- It yields acceptable complication rates and preserves renal function.
- Low positive surgical margin rates support NSS for challenging cases.
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