TY - JOUR
T1 - Compensatory renal growth in children with unilateral renal tumor treated by nephron-sparing surgery or nephrectomy
AU - Cozzi, Francesco
AU - Zani, A.
AU - Schiavetti, A.
AU - Morini, F.
AU - DeGaetano, V.
AU - Matrunola, M.
AU - Cozzi, D. A.
PY - 2007/12
Y1 - 2007/12
N2 - Introduction: In children with an unilateral renal tumor, nephron-sparing surgery (NSS) results in a more adequate renal function adaptation compared to nephrectomy. In the present study, we investigated whether nephron-sparing surgery is followed by a different renal structure adaptation compared to nephrectomy. Methods: Sixteen patients with unilateral renal tumor treated by nephrectomy (Group 1) and 10 treated by nephron-sparing surgery (Group 2) were enrolled in the study. Kidney volume was estimated by ultrasonography, using the formula for a prolate ellipsoid. Kidney volume was adjusted to the patient's weight and kidney laterality and expressed as a percentage of the expected volume of two kidneys in a healthy child. Total kidney volume (TKV) corresponded to the volume of the contralateral kidney in Group 1 patients, and to the volume of contralateral kidney + kidney remnant in Group 2 patients. Renal function was evaluated by serum creatinine values adjusted for sex and age and expressed as standard deviation scores (SDS). Results: Group 2 patients presented with a greater indexed TKV compared to Group 1 patients, (97.4 ± 18.8% vs. 77.0 ± 17.7%; p = 0.005). Indexed TKV below the reference range for healthy controls with two kidneys was found in 4 of 10 Group 2 patients vs. 14 of 16 Group 1 patients (p = 0.017). In both patient groups, correlation analysis of indexed TKV and creatinine SDS showed a negative correlation (r = -0.47; p = 0.01). Conclusion: In children with unilateral renal tumor, NSS is followed by a more adequate compensatory restoration of TKV compared with nephrectomy.
AB - Introduction: In children with an unilateral renal tumor, nephron-sparing surgery (NSS) results in a more adequate renal function adaptation compared to nephrectomy. In the present study, we investigated whether nephron-sparing surgery is followed by a different renal structure adaptation compared to nephrectomy. Methods: Sixteen patients with unilateral renal tumor treated by nephrectomy (Group 1) and 10 treated by nephron-sparing surgery (Group 2) were enrolled in the study. Kidney volume was estimated by ultrasonography, using the formula for a prolate ellipsoid. Kidney volume was adjusted to the patient's weight and kidney laterality and expressed as a percentage of the expected volume of two kidneys in a healthy child. Total kidney volume (TKV) corresponded to the volume of the contralateral kidney in Group 1 patients, and to the volume of contralateral kidney + kidney remnant in Group 2 patients. Renal function was evaluated by serum creatinine values adjusted for sex and age and expressed as standard deviation scores (SDS). Results: Group 2 patients presented with a greater indexed TKV compared to Group 1 patients, (97.4 ± 18.8% vs. 77.0 ± 17.7%; p = 0.005). Indexed TKV below the reference range for healthy controls with two kidneys was found in 4 of 10 Group 2 patients vs. 14 of 16 Group 1 patients (p = 0.017). In both patient groups, correlation analysis of indexed TKV and creatinine SDS showed a negative correlation (r = -0.47; p = 0.01). Conclusion: In children with unilateral renal tumor, NSS is followed by a more adequate compensatory restoration of TKV compared with nephrectomy.
KW - Ablative renal surgery
KW - Kidney volume
KW - Nephroblastoma
KW - Partial nephrectomy
KW - Wilms' tumor
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U2 - 10.1055/s-2007-989219
DO - 10.1055/s-2007-989219
M3 - Article
C2 - 18072020
AN - SCOPUS:38049125474
VL - 17
SP - 382
EP - 386
JO - European Journal of Pediatric Surgery
JF - European Journal of Pediatric Surgery
SN - 0939-7248
IS - 6
ER -