2019, Number 3
Clinical characteristics and functional and oncologic results of patients with kidney tumors that underwent partial nephrectomy
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ABSTRACTBackground: Partial nephrectomy has become standard treatment for T1 tumors (≤ 7 cm), solitary kidney, bilateral tumors, and hereditary cancer. There are few studies in Mexico that report on said procedure.
Aim: To know the clinical characteristics, perioperative morbidity, and functional and oncologic results of partial nephrectomy at the Instituto Nacional De Cancerología
Materials and methods: A retrospective, analytic study was conducted on patients that underwent partial nephrectomy within the time frame of 2000 to 2018, reporting the oncologic and perioperative results.
Results: Seventy-nine patients that underwent partial nephrectomy were analyzed. A total of 82 procedures were performed. Mean patient age was 52 years. Clinical stage was T1a and T1b in 62 (74.6%) and 20 (24.4%) cases, respectively. Warm ischemia was utilized in 39 (47.6%) patients and n ischemia was used in 35 (42.7%). Mean surgery duration was 162 min, mean blood loss was 449 ml, and mean hospital stay was 2.1 days. Open surgery was performed on 70 (85.4%) patients and 12 (14.6%) patients underwent the laparoscopic procedure. There were early complications in 17 (20%) patients that included 9 (11%) transfusions. Clear cell renal cell carcinoma was reported in 66 (80.5%) cases and surgical margins were negative in 73 (89%). Cancer-specific survival was 100% and overall survival was 92% at five years. The mean preoperative estimated glomerular filtration rate was 88 ml/min and it was 79 ml/min at one year. Renal ischemia influenced the decrease in the glomerular filtration rate.
Conclusions: The results of the present study are similar to those reported in other international referral centers, making the performance of partial nephrectomy in T1 tumors a safe procedure in our population.
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