| [Experience in nephron-sparing surgery in patients with small renal tumors]. - UroToday |
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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. CONCLUSIONS - 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. Cir Cir. 2015 Jun 22. pii: S0009-7411(15)00090-0. doi: 10.1016/j.circir.2015.05.016. [Epub ahead of print] [Article in Spanish] 1 Servicio de Urología, Unidad Médica de Alta Especialidad, General Manuel Ávila Camacho, Instituto Mexicano del Seguro Social Puebla, Puebla, México. |