KIDNEY OPEN RESECTION IN RENAL CELL CARCINOMA

• Published in: Vestnik urologii (Online) Vol. 6; no. 2; pp. 54 - 61
• Main Authors: S. V. Shkodkin, Yu. B. Idashkin, S. A. Fironov, V. V. Fentisov, A. N. Udovenko
• Format: Journal Article
• Language: Russian
• Published: State Budget Educational Institute of Higher Professional Education, Rostov State Medical University, Ministry Health of Russian Federation 01.07.2018
• Subjects: kidney tumor; nephron-sparing surgery; renal cell carcinoma; resection of the kidney
• ISSN: 2308-6424
• DOI: 10.21886/2308-6424-2018-6-2-54-61

Introduction. Generally recognized critical moments in kidney resection are the time of ischemia and the adequacy of hemostasis. Until now, one of the main contraindications to nephron-sparing treatment is the inability to provide hemostasis in middle-segment tumors, especially when they are intrarenal.Purpose of research. To evaluate the effectiveness of open resection of the kidney.Materials and methods. For the period 2005 to 2018 us made 152 open partial nephrectomy (OPN) for renal cell carcinoma. The algorithm OPN included extra peritoneal lumbotome access in the IX intercostal space with resection of the X rib resection under conditions of warm ischemia for compression of the blood vessel, in 92.8% of cases completed the clamping of segmental or aberrant arteries. Resection was performed, retreating from the tumor 0.5-1 cm within the unchanged renal parenchyma.Results. The mean age of patients was 55.4±16.2 years; male/female ratio was 52.6/47.4%; right-sided/ left-sided tumor localization was 42.1/57.9%, respectively. The duration of the operation was 109.6±56.7 min, the time of partial ischemia was 15.1±8.3 min, the volume of blood loss was 258±93 ml the Discharge along the drains lasted for 4-12 hours after the operation and averaged 35.7±22.1 ml. Patients were activated after 24 hours, when the urethral catheter was removed, in 59 (38.8%) cases, bladder drainage was not performed. Average postoperative hospital stay was 10.1±4.2 per day.Conclusion. The technique of open resection of the kidney with a margin from the border of the visible tumor and visual control of the surgical edge provides good oncological results, does not require the «Express» histology and is an alternative to nephrectomy in patients with high risk of complications, calculated on morphometric scales.Disclosure: The study did not have sponsorship. The authors declare no conflict of interest.