T1 renal kitlelerde açık nefron koruyucu tedavi: Cerrahi, onkolojik ve fonksiyonel sonuçlarımız

Objective: We aimed to present surgical, oncological, and functional outcomes. We aimed to present surgical, oncological and functional outcomes of patients with T1 stage renal tumour which were treated with nephron-sparing surgery.Materials and Methods: A total of 36 patients who had undergone nephron-sparing surgery NSS between 2004, and 2012 for the management of previously identified renal masses of < 7 cm were included in our study. Demographic data, radiological, and histopathological characteristics of the cases, and the follow-up periods were retrospectively evaluated. During postoperative follow-up period whole abdomen was scanned with magnetic resonance imaging technique so as to evaluate local recurrences. Results: We performed retroperitoneal NSS using open technique on a total of 36 patients 19 women, and 17 men with a median age of 54 years range, 23-88 yrs . Mean diameter of the tumours was detected to be 2.9x2.5 cm. Three 8 % patients had bilateral renal masses. Warm ischemia had been used intraoperatively for 2 patients, and for the remaining patients this procedure was achieved without ischemia. Median pre- and postoperative creatinine values were 0.87, and 0.96 mg/dl, respectively. Increase in postoperative creatinine values were not found to be statistically significant p=0.81 . Any increase in postoperative creatinine values was not observed in 2 patients who had been operated under warm ischemia. Median follow-up period was 39 months 8-92 mos . Local recurrence or distant metastasis was not observed in any patient. Disease –specific, and overall survival rates were similar, and detected as 100 percent. Conclusion: Currently, open partial nephrectomy is the most frequently employed method of nephron-sparing surgery. It retains its place as a safely performed modality to be used in the management of renal tumours with proper indications, and oncological results similar to those of radical nephrectomy, but lesser risk of development of chronic renal disease