Partial nephrectomy for solid renal masses in polycystic kidneys: open surgical technique.

Area of Science:

• Nephrology
• Urologic Oncology
• Surgical Techniques

Background:

• Partial nephrectomy is standard for small renal masses, prioritizing renal function preservation.
• Minimally invasive surgery is common, but open partial nephrectomy remains crucial for complex cases.
• Partial nephrectomy in autosomal dominant polycystic kidney disease (ADPKD) patients presents unique challenges and is infrequently reported.

Purpose of the Study:

• To describe the open surgical technique for partial nephrectomy in patients with multicystic kidneys and solid renal masses.
• To evaluate the feasibility and outcomes of this approach in patients not on renal replacement therapy (RRT).

Main Methods:

• Case series illustrating the open surgical technique for partial nephrectomy.
• Focus on patients with multicystic kidneys and solid renal masses, all with early chronic kidney disease.
• Surgical approach detailed for patients not on RRT.

Main Results:

• Successful open partial nephrectomy was performed in three patients with multicystic kidneys and solid renal masses.
• All patients had early chronic kidney disease, with partial nephrectomy chosen to preserve renal function.
• Patients maintained stable creatinine levels and remained recurrence-free post-surgery.

Conclusions:

• Open partial nephrectomy is an important surgical option for challenging kidney tumors, including those in multicystic kidneys.
• Patients with ADPKD and renal masses should be considered for nephron-sparing surgery.
• Management of ADPKD patients with solid renal masses should align with general population guidelines, favoring kidney-sparing approaches.