Оrgan-preserving surgery of renal cancer

Keywords: renal resection; resection of a single kidney; renal cancer; thermal ischemia; renal decapsulation; оrgan-preserving surgery; laparoscopy; laparoscopic renal resection

Abstract

Objective. To present own experience in a light of generally accepted tendencies in organ-preserving surgery of renal cancer.

Маterials and methods. From 2008 tо Dec. 2017 yr there were performed 127 renal resections, of them 32 - laparoscopically, in 111 observations - for renal cancer.

Results. In open renal resection in 74% of observations the thermal ischemia was applied during 10 - 27 min, 14 min at average. During laparoscopic renal resection the thermal ischemia was used in 82% of observations, its duration have constituted 9 - 39 min, 26 min at average. Average duration of operation in laparoscopic renal resection have constituted (170 ± 40) min, while the open access one - (104 ± 40) min. After both types of operations a histologically negative edge of resection was confirmed. During period of observation a recurrence of a renal-cellular cancer was revealed in 3 (2.4%) patients after open renal resection on Stage T3a (histologically - tumoral emboli in segmental vessels). Laparoscopic nephrectomy was done in all of these patients. A disease-free survival have constituted 97.6%.

Conclusion. Performance of laparoscopic renal resection is secure in patients with tumor in Stage рТ1 and is not connected with big quantity of perioperative complications, comparing with open renal resection, but in this situation a duration of  renal thermal ischemia enhances trustworthily. For strictly selected patients among operative accesses it is mandatory to choose those, which may be conducted without renal thermal ischemia.

Author Biographies

S. P. Styopushkin, Dnepropetrovsk Municipal Multidisciplinary Clinical Hospital № 4, Сity of Dnepr

Styopushkin Sergiy P. - MD, PhD (Med).

Head of Department of Urology #1,

Dnipropetrovsk City Multifield Clinical Hospital #4 “DRU”

31, Blyzhnya Street, 49102, Dnipro, Ukraine

+380562583291

step74@ukr.net

https://orcid.org/0000-0001-7841-2484

V. P. Chaikovskyi, Dnepropetrovsk Municipal Multidisciplinary Clinical Hospital № 4, Сity of Dnepr

Chaikovskyi Viktor P. - MD.

Physician in Department of Urology #1,

Dnipropetrovsk City Multifield Clinical Hospital #4 “DRU”

31, Blyzhnya Street, 49102, Dnipro, Ukraine

+380562583291

witamin@ukr.net

https://orcid.org/0000-0001-7974-3656

R. V. Sokolenko, Dnepropetrovsk Municipal Multidisciplinary Clinical Hospital № 4, Сity of Dnepr

Sokolenko Ruslan V. - MD.

Physician in Department of Urology #1,

Dnipropetrovsk City Multifield Clinical Hospital #4 “DRU”

31, Blyzhnya Street, 49102, Dnipro, Ukraine

+380562583291

uroson@ukr.net

https://orcid.org/0000-0002-9083-4177

V. A. Chernilovskyi, Dnepropetrovsk Municipal Multidisciplinary Clinical Hospital № 4, Сity of Dnepr

Chernylovskyi Volodymyr A. - MD.

Physician in Department of Urology #1,

Dnipropetrovsk City Multifield Clinical Hospital #4 “DRU”

31, Blyzhnya Street, 49102, Dnipro, Ukraine

+380562583291

chernylovskyi@gmail.com

https://orcid.org/0000-0002-5795-1574

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Published
2018-10-29
Section
General Problems of Surgery