Trends in Surgical Management of Renal Neoplasms: Single Center Results in the Last Decade
The majority of renal neoplasms can be treated surgically using open or minimally- invasive approach. Nephron-sparing surgery should be used when possible, regardless to the operative approach. In this retrospective study, we analyzed surgical trends of operative treatment of renal neoplasms in t...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
2023-01-01
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| Series: | Acta Clinica Croatica |
| Subjects: | |
| Online Access: | https://hrcak.srce.hr/file/446353 |
| Summary: | The majority of renal neoplasms can be treated surgically using open or minimally-
invasive approach. Nephron-sparing surgery should be used when possible, regardless to the operative
approach. In this retrospective study, we analyzed surgical trends of operative treatment of renal neoplasms
in the period from February 2011 until December 2020. There were a total of 1031 procedures,
703 (68.2%) radical nephrectomies (RN) and 328 (31.8%) partial nephrectomies (PN). Laparoscopic
approach was used in 211 (20.5%) (111 PN and 100 RN), while open approach was used in 820 (79.5%)
(328 PN and 703 RN) cases. There were 12 procedures performed with the use of cardiopulmonary bypass
and hypothermic arrest. The median operative time was 161 minutes for open RN and 158 for open
PN, 160 for laparoscopic RN, and 162 for laparoscopic PN. The most common pathology was clear cell
carcinoma in 693 (67.3%), papillary carcinoma in 115 (11.2%), chromophobe carcinoma in 67 (6.5%),
oncocytoma in 46 (4.5%), and angiomyolipoma in 33 (3.2%) patients. Pathologically, pT1 stage was
diagnosed in 56.9%, pT2 in 5.8%, pT3 in 22.4% and pT4 in 1.2% of patients. Regional lymphadenectomy
was performed in 354 (34.3%) patients, among which lymph nodes were positive in 40 (11.3%)
cases. Surgical margins were positive in 27 cases when PN was performed (8.2%). In conclusion, there
was an ongoing raising trend in the number of procedures in general, and also in minimally invasive and
nephron-sparing surgery in our study. |
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| ISSN: | 0353-9466 1333-9451 |