Clinical effect of nephron sparing surgery in treatment of anatomic solitary renal carcinoma
WANG Shaoliang1, WANG Shulong1, CHEN Rong2, ZHANG Kunlin3, SHI Xuan4
1. Department of Urology, 2. the Second Department of Characteristics Medicine, 3. Medical Imaging Department, 4. Medical Psychology Department, Hubei Provincial Corps Hospital of Chinese People's Armed Police Force, Wuhan 430060, China
Abstract:Objective To investigate the clinical effect of nephron sparing surgery in the treatment of anatomic solitary renal tumor. Methods A retrospective analysis was conducted on 12 patients with anatomic solitary renal tumor admitted to Hubei Provincial Corps Hospital of Chinese People's Armed Police Force from April 2010 to November 2019, including 8 males and 4 females, with an average age of (48.67±2.34) years. The tumor was 4.62 cm (2.2-8.2 cm). The clinical stage was T1aN0M0 in 4 patients, T1bN0M0 in 6 cases and T2N0M0 in 2 cases. All the 12 patients underwent surgical treatment, including open nephron sparing surgery in 9 cases and laparoscopic nephron sparing surgery in 3 cases. The results of renal function reexamination on the day and 1 week after operation of the two different operation methods were analyzed, and the operation time, blood loss and hot ischemia time were analyzed. The patients were followed up for 12 to 36 months and the prognosis was analyzed. Results All the 12 patients completed the operation successfully. The open operation time of 9 cases was 142 min (115-172 min), the blood loss was 253 ml (175-420 ml), and the warm ischemia time was 34 min (25-41 min). The laparoscopic operation time of 3 cases was 112 min (96-131 min), the blood loss was 197 ml (120-270 ml) and the warm ischemia time was 25 min (23-27 min). The mean serum creatinine values were 239 μmol/L (136-302 μmol/L) and 186 μmol/L (92-287 μmol/L) on the day and 1 week after surgery respectively. None of the 12 patients underwent perioperative blood transfusion, and laparoscopic surgery was not converted to open one. There were no serious complications such as bleeding, urine leakage, intestinal obstruction or acute kidney injury during the perioperative period, and no need for temporary blood dialysis. After operation, there were 7 cases of renal clear cell carcinoma, 4 cases of renal papillary cell carcinoma and 1 case of renal chromophobe cell carcinoma. All the 12 cases were followed up after surgery, and 1 case was lost to follow-up. One patient died of pneumonia 10 months after surgery, one patient died of cardiovascular accident 21 months after surgery, and the remaining 9 patients survived with no tumor. Conclusions Nephron sparing surgery is effective in the treatment of anatomic solitary renal carcinoma.
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