Evaluation Of Nephron Sparing Surgery For Renal Cell Carcinoma

Objective:To evaluate the results and feasibility of nephron-sparing surgery for renal tumors.Materials and Methods:we retrospectively analyzed a total of 21 patients who had undergone nephron sparing surgery for renal cell carcinoma between Aug 2003 and Dec 2006,12 males and 9 females were involved in this study. The mean age was 44 years old(26-70 years). Among these patients , 4cases with relative indications , and 17 cases with elective indications. The tumor's diameter ranged from 1.0cm to 5.0 cm, all tumor staged in T₁N₀M₀ . We also selected 25 patients matched for age, tumor location and stage who underwent radical nephrectomy at same period as comprasion group .Of which there were 15 males, mean age was 47 years old(26⁷0years).The time of hospital stay and operation time, amount of blood lost during operation,complications rate in post-operation, tumor recurrence and survival rate were compared between the two groups. Otherwise, we divide the NSS group into two groups as:blocked-renal pedicle groups(13cases) and unblocked-renal pedicle groups(8cases).Compared the amount of blood losing and time of operation. Determined the creatinine in serum of blocked-renal pedicle groups at preoperation and post-operation stage.Results:All procedures were successful. 12 cases were underwent partial nephrectomy and 9 cases with enucleation. The renal vessel was clamped in 13 cases intra-operative, The mean time of hot ischemia was 18mins(12-28min).Histological subtype showed clear cell carcinoma in 19 cases, chromophobe cell carcinoma in 1 case, granular cell carcinoma in 1 case .Surgical margins were negative in all cases. 1 patient had postoperative complication and others had not. There is no significant difference between the NSS group and RN group in time of hospital stay and operation ,amount of blood losing intra-operation ,complication rate in post-operation, tumor recurrence and survival rate. Clamping the renal vessel can decrease blood losing intra- operation and influence on renal function slightly in limited time.Conlusion:The NSS is safe and effective procedure for renal tumor and should be used widely in clinic. Clamping the renal vessel can decrease blood losing intra-operation effectively and influence on renal function slightly in limited time.