Radical and partial nephrectomy

S. Ovčariček, B. Mažuran, M. Sučić, I. Kožul, A. El Saleh, I. Gilja,

Department of Urology, Clinical Hospital Sveti Duh, Zagreb

Introduction: Surgical removal of localised renal cell carcinoma remains potentially curative therapy. Our aim is to compare results of nephron sparing therapy and radical nephrectomy.

Methods: During last 2 years 30 patients were treated using partial nephrectomy (PN) and 67 patients using radical nephrectomy (RN). Patients were 42-75 years old and average tumor size in PN group was 37.8 mm, and in RN group 73.2 mm. They were evaluated during 6-24 months postoperatively. We were observing surgical complications, warm ischaemia duration, perioperative transfusion, creatinine level and recurrence (diagnosed by ultrasound and MSCT).

Results: All patients in follow up period haven’t shown signs of tumor recurrence. Perioperative mortality was zero. We had one significant complication in PN group and that was a need for radical nephrectomy in order to stop massive renal bleeding during first postoperative day. Postoperative creatinine level in PN group was 64-150 µmol/l, average 111 µmol/l and in RN group 96-414 µmol/l, average 149 µmol/l. In PN group we gave blood transfusion perioperatively to 8 patients and in RN group we gave it to 12 patients. In 12 patients warm ischaemia with average duration of 11.3 min was done.

Conclusion: Good oncological outcome and preserved renal function makes partial nephrectomy procedure of choice in treating localized renal tumors.