Clinical Analysis Of Incidental Renal Carcinoma Treated By Nephron-Sparing Surgery

Objective: To explore the clinical effect of nephron sparing surgery(NSS)for incidental renal cell carcinoma in order to improve its treatment effect.Methods: The clinical data of 11 cases of incidental RCC treated with NSS from 2012 to2014 was reviewed retrospectively and compared with 9 cases of radical nephrectomy(RN)and 8 cases of conservative treatment of patients with incidental renal cell carcinoma at corresponding time period.Results: There was no significant difference in age,sex between the NSS group and RN group and the conservative treatment group(p?0.05).Compared to the RN group and the conservative treatment group,the diameter of NSS group[(3.1 ± 1.0cm)] was smaller(t1=7.2,t2=5.6,p<0.01),as well as the pathological stage(?2 =31.72,p<0.01).There were also great quantity differences found in position of tumor,pathological type,lymph node enlargement and thrombus of vena cava system between the three groups.The creatinine value 24 hours after operation of the NSS group was significantly better than that of RN group,the difference was significant(t=6.21,p<0.01).The intraoperative blood loss,drainage volume and operation time of NSS group were slightly higher than those of RN group,but the difference was not significant(p?0.05).The 3-and 5-year cancer specific survival rates in patients with incidental RCC which treated with NSS were higher than other two groups(p<0.01).In the same case,the effect of surgical treatment of NSS group was significantly higher than other two groups(?2 =13.035,p<0.01).Conclusion: NSS is an effective method to treat carefully selected incidental RCC patients.While retaining most of the functions of the kidney,its postoperative complications are relatively small and the prognosis is relatively good.