INTRODUCTION AND OBJECTIVES: Elective nephron sparing surgery in patients with low stage renal cell carcinoma and a normal controlateral kidney, is an intriguing but yet to be established alternative to radical nephrectomy. It remains a matter of controversial debate the maximum tumor size, the surgical approach and the surgical technique required for this procedure. In this study we have considered the clinical outcome of a group of patients submitted to elective tumor enucleation for small (≤ 5 cm) renal cell carcinoma. METHODS: 36 patients (mean age 59.6 years) with a small (≤ 5 cm) solitary renal cancer and a normal controlateral kidney were submitted to tumor enucleation through a transperitoneal approach. Frozen step sections of surgical margins were examined intraoperatively. The mean follow-up time is 38 months. RESULTS: Bleeding could be controlled without clamping the renal artery in 22 cases, while renal ischemia was necessary in the remaining 14 cases (mean ischemia time: 16 minutes). The mean surgical bleeding was 420 cc. Frozen sections of the surgical margins were negative in all cases. Renal function remained normal in all cases. One patient, with a tumor size of 4.6 cm at the time of nephron sparing surgery, experienced local recurrence 12 months postoperatively and underwent radical nephrectomy. All patients are alive and cancer free. CONCLUSIONS: Elective tumor enucleation for small (≤ 5 cm) renal cell carcinoma can be conducted safely and with low risk of local recurrence. Longer follow-up and randomized series versus standard radical nephrectomy and other techniques for nephron sparing surgery are required before this procedure can be more widely recommended in clinical practice.
|Number of pages||1|
|Journal||British Journal of Urology|
|Issue number||SUPPL. 2|
|Publication status||Published - 1997|
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