Comparison Of Nephron-Sparing Surgery VS Radical Nephrectomy In Patients With Renal Cell Carcinoma:Diagnosis And Treatment

Objective:To compare the clinical characteristics, operation effect and the recovery of patients after operation between cell carcinoma using nephron sparing surgery (NSS) and radical nephrectomy (RN).Methods:Clinical data of 463 hospitalized patients with renal cell carcinoma in our hospital from September 2008 to September 2013 were retrospectively analyzed. According to imaging data and postoperative pathological results in 2010 AJCC kidney cancer standard stage,selecting 253 unilateral renal cell carcinoma patients in stage 1.It’s divided into NSS group and RN group, Which the NSS group has 99 patients including 65 male and 34 female, average age 56.70±13.59 years old,19 cases patients with clinical symptoms and 80 cases patients without clinical symptoms,89 cases patients was clear cell carcinoma; Which the RN group has 154 patients including 98 male and 56 female, average age 57.64±12.39 years old,70cases patients with clinical symptoms and 84 cases patients without clinical symptoms,138 cases patients was clear cell carcinoma.Comparing different surgical mode in patients with clinical characteristics, operation situation, postoperative follow-up。Result:Early renal cell carcinoma without obvious clinical symptoms, and usually firstly diagnosed by B-ultrasound during the period of hospitalization or physical examination. Our hospital find the renal cell carcinoma patients firstly by B ultrasound accounted for 76.28%.Difference between NSS group and RN group in aspects of age, the tumor side, pathological results, the recurrence、metastasis and disease-free survival rate at 3 years,preoperative creatinine,3 moths and 12 moths after operation creatinine were not significant (P>0.05).There were significant difference in the clinical symptoms,postoperative 24 hours creatinine,bleeding during operation, operation time between the two groups (P<0.05).RN group has more patients with clinical symptoms (19 cases Vs70 cases,19.2%vs45.5%), The NSS group has more intraoperative bleeding than the RN group (136.87ml vs 100.26ml), operation time longer (119.17min vs 108.57mm), but the renal damage more slightly,the local recurrence(4 cases vs8 cases) and distant metastasis(4 cases vs9 cases) had no significant difference, disease-free survival rate had no significant difference (96.8%vs95.9%).Conclusions:B-Ultrasound is helpful to early kidney cancer screening, we find enough evidence that nephron sparing surgery is better than radical nephrectomy. And nephron sparing surgery could maximally preserve the nephron and its function,which helps to improve the post-operative quality of life。...