Elective open nephron-sparing surgery for renal masses: Single-center experience with 223 consecutive patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16139-e16139
Author(s):  
F. Francesca ◽  
G. Pomara ◽  
G. Campo ◽  
P. Casale
Keyword(s):  
Postoperative Bleeding ◽  
Oncologic Outcome ◽  
Nephron Sparing Surgery ◽  
Consecutive Series ◽  
Renal Masses ◽  
Single Center Experience ◽  
Nephron Sparing ◽  
Urinary Fistulas

e16139 Background: To present our experience with elective, open, nephron-sparing surgery for renal masses in a contemporary, consecutive series. Methods: In this retrospective study, records of all patients who underwent elective nephron-sparing surgery (E-NSS) between March 1997 and December 2007 at our institution were reviewed. The preoperative workup included laboratory analysis, renal ultrasonography and abdominal computed tomography. The histological findings, complications, and oncologic outcome were studied. Results: A total of 231 E-NSS were performed in 223 patients (82 females,141males; mean age 64 years). 62 “hot ischemia” procedures and 169 “cold ischemia”. The mean tumor size was 4.6 cm (1.1–12cm). 52 patients presented renal masses > 4cm. Renal cell carcinoma was present in 177 patients (76.6%), benign renal masses were diagnosed in in 54 pazienti (23.3%): angiomyolipoma (35%), oncocytoma (40%), complicated cyst (25%). Worthy of note among these 54 patients, pre-operative diagnosis was present in 12 patients. Moreover, 17 benign lesions (31%) were > 4 cm. Complication rate was 5.3% (12 pts): splenectomy (2.2%), nephrectomy because of postoperative bleeding (0.8%), urinary fistulas (0.8%). After a median follow-up of 84 months (range 5 to 120), no patient had developed local recurrence, 19 (8.9%) died for other causes, 2 (0.9%) died for other tumor. Conclusions: The results of this contemporary, monocenter experience underline the role of open, elective, nephron-sparing surgery for patients with renal masses, confirming good results even for renal masses > 4cm. These conclusions are particularly important considering that benign histologic findings were present in almost one forth of patients. No significant financial relationships to disclose.

Elective open nephron-sparing surgery for renal masses: single-center experience with 129 consecutive patients

Urology ◽  
2004 ◽  
Vol 64 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Martin Marszalek ◽  
Anton Ponholzer ◽  
Clemens Brössner ◽  
Johann Wachter ◽  
Ulrich Maier ◽  
...  
Keyword(s):  
Nephron Sparing Surgery ◽  
Single Center ◽  
Renal Masses ◽  
Single Center Experience ◽  
Nephron Sparing

scholarly journals Nephron-Sparing Surgery for Renal Masses Measuring Larger Than 7 cm on Preoperative Imaging: A Single Surgeon, Single Center Experience

ISRN Surgery ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Tarık Esen ◽  
Ömer Acar ◽  
Ahmet Musaoğlu ◽  
Metin Vural ◽  
Sergin Akpek
Keyword(s):  
Nephron Sparing Surgery ◽  
Preoperative Imaging ◽  
Imaging Studies ◽  
Renal Masses ◽  
Contralateral Kidney ◽  
Single Center Experience ◽  
Nephron Sparing ◽  
Clavien Grade ◽  
Study Population ◽  
Benign Histology

Objectives. To document the feasibility of nephron-sparing surgery (NSS) for the surgical treatment of renal masses measuring larger than 7 cm (cT2) on preoperative imaging. Methods. A total of 139 patients have undergone NSS between 2001 and 2012 by a single surgeon in our clinic. Of these, we identified 17 patients whose tumors were measuring greater than 7 cm on preoperative imaging studies and were limited to the kidney. Their charts were retrospectively reviewed. Results. Mean age of the study population was 49.8±11.3 years. Thirteen patients were managed by open NSS, while 4 patients have undergone robot-assisted NSS. Mean diameter and mean R.E.N.A.L. score of the tumors that were enucleoresected were 8.2 cm and 8.5, respectively. A total of 5 Clavien grade 2 and higher complications were recorded within 30 days of surgery. Histopathologic examination revealed benign histology in almost 1/4 of the cases. After a median followup of 33 months, all of our patients were alive. Only one patient (5.8%) experienced local recurrence. Conclusions. NSS is a feasible and safe option for large (>7 cm) renal masses. It may be considered not only for imperative conditions but also for highly selected cases with a normal contralateral kidney.

scholarly journals [45] Role of nephrometry scoring systems (R.E.N.A.L.-PADUA) in planning nephron-sparing surgery in patients with renal masses: Retrospective study of 88 cases

2018 ◽  
Vol 16 (sup1) ◽  
pp. S21-S22
Author(s):  
Abdelkrim Boulatrous ◽  
Nassim Laskri ◽  
Soumeya Lekouaghet ◽  
Karim Atoui ◽  
Abdelhalim Chouakria ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Scoring Systems ◽  
Nephron Sparing Surgery ◽  
Renal Masses ◽  
Nephron Sparing

scholarly journals Surgical margin follow-up after nephron-sparing surgery: the possible role of CEUS

2019 ◽  
Vol 23 (4) ◽  
pp. 515-520
Author(s):  
Elena Bertelli ◽  
Laura Mercatelli ◽  
Elena Savi ◽  
Alessandro Pili ◽  
Silvia Verna ◽  
...  
Keyword(s):  
Surgical Margin ◽  
Nephron Sparing Surgery ◽  
Nephron Sparing

scholarly journals The Natural History and Predictors for Intervention in Patients with Small Renal Mass Undergoing Active Surveillance

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Zaher Bahouth ◽  
Sarel Halachmi ◽  
Gil Meyer ◽  
Ofir Avitan ◽  
Boaz Moskovitz ◽  
...  
Keyword(s):  
Natural History ◽  
Active Surveillance ◽  
Renal Mass ◽  
Nephron Sparing Surgery ◽  
Small Renal Mass ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Nephron Sparing ◽  
The Mean

Aim. To describe the natural history of small renal mass on active surveillance and identify parameters that could help in predicting the need for intervention in patients with small renal masses undergoing active surveillance. We also discuss the need for renal biopsy in the management of these patients.Methods. A retrospective analysis of 78 renal masses ≤4 cm diagnosed at our Urology Department at Bnai Zion Medical Center between September 2003 and March 2012.Results. Seventy patients with 78 small renal masses were analyzed. The mean age at diagnosis was 68 years (47–89). The mean follow-up period was 34 months (12–112). In 54 of 78 masses there was a growth of at least 2 mm between imaging on last available follow-up and diagnosis. Eight of the 54 (15%) masses which grew in size underwent a nephron-sparing surgery, of which two were oncocytomas and six were renal cell carcinoma. Growth rate and mass diameter on diagnosis were significantly greater in the group of patients who underwent a surgery.Conclusions. Small renal masses might eventually be managed by active surveillance without compromising survival or surgical approach. All masses that were eventually excised underwent a nephron-sparing surgery. None of the patients developed metastases.

Functional and oncological outcomes of open nephron-sparing surgery for complex renal masses

2015 ◽  
Vol 33 (10) ◽  
pp. 427.e11-427.e16 ◽  
Author(s):  
Zaher Bahouth ◽  
Sarel Halachmi ◽  
Itamar Getzler ◽  
Orna Caspin ◽  
Boaz Moskovitz ◽  
...  
Keyword(s):  
Nephron Sparing Surgery ◽  
Renal Masses ◽  
Oncological Outcomes ◽  
Nephron Sparing

scholarly journals LAPAROSCOPIC RESECTION OF GASTROINTESTINAL STROMAL TUMORS (GIST)

2016 ◽  
Vol 29 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Marcelo de Paula Loureiro ◽  
Rômulo Augusto Andrade de ALMEIDA ◽  
Christiano Marlo Paggi Claus ◽  
Eduardo Aimoré Bonin ◽  
Antônio Moris Cury-Filho ◽  
...  
Keyword(s):  
Operative Time ◽  
Laparoscopic Resection ◽  
Postoperative Bleeding ◽  
Imatinib Treatment ◽  
Stromal Tumors ◽  
Single Center Experience ◽  
Absorbable Sutures ◽  
Mechanical Suture ◽  
Laparoscopic Techniques

Background : Gastrointestinal mesenchymal or stromal tumors (GIST) are lesions originated on digestive tract walls, which are treated by surgical resection. Several laparoscopic techniques, from gastrectomies to segmental resections, have been used successfully. Aim : Describe a single center experience on laparoscopic GIST resection. Method : Charts of 15 operated patients were retrospectively reviewed. Thirteen had gastric lesions, of which ten were sub epithelial, ranging from 2-8 cm; and three were pure exofitic growing lesions. The remaining two patients had small bowel lesions. Surgical laparoscopic treatment consisted of two distal gastrectomies, 11 wedge gastric resections and two segmental enterectomies. Mechanical suture was used in the majority of patients except on six, which underwent resection and closure using manual absorbable sutures. There were no conversions to open technique. Results : Mean operative time was 1h 29 min±92 (40-420 min). Average lenght of hospital stay was three days (2-6 days). There were no leaks, postoperative bleeding or need for reintervention. Mean postoperative follow-up was 38±17 months (6-60 months). Three patients underwent adjuvant Imatinib treatment, one for recurrence five months postoperatively and two for tumors with moderate risk for recurrence . Conclusion : Laparoscopic GIST resection, not only for small lesions but also for tumors above 5 cm, is safe and acceptable technique.

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