Clinical Analysis Of Nephron-sparing Surgery For Localized Renal Cell Carcinomas In 175 Cases

Objective: To evaluate the results of Nephron-sparing surgery for localized renal cell carcinomas.Material & Methods: A retrospective analysis was peroformed for 171 patients who were affected by renal cell carcinoma and treated with nephron-sparing sugery between June 1999 and November 2005.There was 4 patients had bilateral tumors and nephron-sparing surgery was performed twice among those patients.Results: Nephron-sparing sugery was done for absolute indication in 23 patients,for relative indication in 50 patients,and for elective indication in 102 patients. All was treated with partial nephrectomy .The renal vessel was clamped in 159 cases intraoperative, the mean intraoperative renal interrupted time was 15 mins(range 5 to 30).The histological subtype was clear cell carcinoma in 163 cases,papillary renal cell carcinoma in 4 cases,chromophobe in 6 cases,multilocular cystic renal cell carinoma in 2 cases. The mean tumor size was 2.8 cm (range 0.5 to 7cm).The mean size of surgical margin was 7 mm and surgical margin were negative in all cases.Eight patients had postoperative complications and no perioperative acute renal failure occurred. After a median follow-up of 33 months (range 3 to 119), one patient had developed local recurrence, one patient had developed distant progression.5 year cancer specific survival rates and overall survival rates were 98.5% and 95.9%.Conclusions: For patients with localized renal cell carcinomas, nephron-sparing surgery can achieve an effective oncologic outcome and a low local recurrence rate, it is an affective and safe operation and can providing functional advantage by the maximal preservation of unaffected renal parenchyma.