Journal
EJSO
Volume 40, Issue 6, Pages 762-768Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ejso.2014.01.007
Keywords
Carcinoma; Renal cell; Partial nephrectomy; Simple enucleation; Pathology; Surgical outcome assessment
Funding
- Leading Urological No profit foundation Advanced research (LUNA) of the Italian Society of Urology
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Objectives: To compare simple enucleation (SE) and standard partial nephrectomy (SPN) in terms of surgical results in a multicenter dataset (RECORd Project). Materials and methods: patients treated with nephron sparing surgery (NSS) for clinical Ti renal tumors between January 2009 and January 2011 were evaluated. Overall, 198 patients who underwent SE were retrospectively matched to 198 patients who underwent SPN. The SPN and SE groups were compared regarding intraoperative, early post-operative and pathologic outcome variables. Multivariable analysis was applied to analyze predictors of positive surgical margin (PSM) status. Results: SE was associated with similar WIT (18 vs 17.8 min), lower intraoperative blood loss (177 vs 221 cc, p = 0.02) and shorter operative time (121 vs 147 mm; p < 0.0001). Surgical approach (laparoscopic vs. open), tumor size and type of indication (elective/relative vs absolute) were associated with WIT >20 mm. The incidence of PSM was significantly lower in patients treated with SE (1.4% vs 6.9%; p = 0.02). At multivariable analysis, PSM was related to the surgical technique, with a 4.7-fold increased risk of PSM for SPN compared to SE. The incidence of overall, medical and surgical complications was similar between SE and SPN. Conclusions: Type of NSS technique (SE vs SPN) adopted has a negligible impact on WIT and postoperative morbidity but SE seems protective against PSM occurrence. (c) 2014 Elsevier Ltd. All rights reserved.
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