Partial nephrecto my for renal cell carci no main a solitary kidney:Experience of 15 cases

GuanYouyan; Xiao Zhendong; Wang Dong; TianJun; Bi Xigang; Guan Kaopeng; Ma Jianhui; Li Changling

Abstract：Objective:To report the experience of partial nephrectomy for renal cell carcinoma in patients with a solitary kidney at our institution,with analysis of renal function,complications ,oncological efficacy and survival . Methods:We identified 15 consecutive patients with a solitary kidney who underwent partial nephrectomy between Jan .1999 and May 2013 .Variables exa mined included patient age and gender ,renal function ,renal ische mia ti me , surgical marginstatusandcomplications.Tumorsize,histologicalsubtypeandtumorstage werealsoassessed.Re-sults:The median age was 50 years (range:39 to 71 ).The male/fe male ratio was 4 :1 .The mean operative ti me was 150 min .The renal artery was occluded in 10 of 15 patients and the mean war mische mia ti me was 24 min .Gentle manual compressiontothekidney wasappliedintheother5 patients.The medianbloodloss was300 mL.The medi-ansizeofthetumor was2.5cm(range:1.5to7.0).Thehistologicalsubtype wasclearcellcarcinomain14cases andpapillarycellcarcinomainonecase.Allsurgical margins werenegative.The mediancreatininelevelincreasedaf-tertheoperationbutthatin11 ofthemhadreturnedtothebaselineone monthaftertheoperationduringthefollow-upperiod.Nopatientrequiredhemodialysis.Perioperativecomplicationsincludedacuterenalfailureandhematuria. The median follow-up was 51 months (range:10 to 167 ).Bone metastasis was found in one patient ,who was dead 32 months after the surgery .Local recurrence was found in 2 patients ,who were treated by target therapy .Conclu-sions:Partial nephrectomyforrenalcellcarcinomainpatients withasolitarykidneycansafelypreserverenalfunction and effecti vel y treat mali gnancy .