OPEN PARTIAL NEPHRECTOMY FOR SMALL RENAL TUMOURS: TECHNICAL AND ONCOLOGICAL OUTCOMES

Qamar Zia; Mudassar Sajjad; Muhammad Akmal; Faran Kiyani; Muhammad Nawaz; Sohail Razzaq

doi:10.51253/pafmj.v71i1.3377

Authors

Qamar Zia Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
Mudassar Sajjad Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan
Muhammad Akmal Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
Faran Kiyani Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Pakistan
Muhammad Nawaz Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Pakistan
Sohail Razzaq Combined Military Hospital Sialkot/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v71i1.3377

Keywords:

Cold ischemia time, Humans, Kidney cancer, Kidney neoplasm, Margins of excision, Nephrectomy, Renal neoplasm, Warm ischemia time

Abstract

Objective: To assess the safety and oncological outcomes of Open Partial Nephrectomy in management of small renal tumours.

Study Design: Case series.

Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Jan 2015 to Dec 2018.

Methodology: We prospectively studied 61 patients with renal tumours either observed on computerized tomography (CT) scan or magnetic resonance imaging (MRI) having size ≤7cm and underwent open partial nephrectomy. The collected data included demographics, dimension of tumour, indication for surgery, cold ischemia time, hospital stay, complications and histopathological finding including involvement of margins. Patients were followed up for atleast 2 years.

Results: Among 61, 39 patients were male and 22 females. The age of patients ranged from 20-72 years. Mean cold ischaemia time was 24.7 ± 6.37 minutes. Except for 2 patients with Von Hippel–Lindau (VHL) disease, all other patients had solitary renal growth. Nine (14.75%) patients had solitary kidney. The mean of maximum dimension of tumours was 3.84 ± 1.38 cm and mean hospital stay was 3.18 ± 2.19 days. Histopathological results showed 34 tumours to be conventional renal cell carcinoma (RCC) (55.73%) followed by 12 papillary renal cell carcinoma (19.67%). Two (3.27%) patients had positive surgical margin who were operated for >5 cm tumours and later managed expectantly. Twenty one patients had Grade I and II complications while 2 patients were stented post operatively for urine leak. At 2 years follow up there was no recurrence of tumour in any of the patient operated.

Conclusion: Open ..........