[Application of nephron-sparing surgery in the treatment of renal cell carcinoma].

OBJECTIVE

To evaluate the application of nephron-sparing surgery (NSS) in the treatment of renal cell carcinoma (RCC).

METHODS

The clinical data of 221 RCC patients who received nephron-sparing surgery were retrospectively reviewed. Open surgery was performed for 203 cases and laparoscopic surgery for 18 cases. The renal arteries were blocked and ice fragments were used for 115 patients. Biopsy was performed on renal tissue adjacent the tumor for 136 patients. After operation 156 patients were treated with interferon and interleukin II. Among these 221 patients, 132 patients (59.7%) were followed for 3-56 months (mean: 28 months).

RESULTS

The mean distance from the edge of normal tissue to the tumor was 0.4 cm (0.2-1.0 cm). The mean volume of blood loss was 180 ml (50-1 000 ml). Pathological examination showed clear cell carcinoma (n = 195), chromophobe renal carcinoma (n = 12), papillary renal carcinoma (n = 7), cystic renal carcinoma (n = 6), and sarcomatoid clear cell carcinoma (n = 1). Biopsies in 136 patients showed negative results. Post-operative complications included leakage of urine (n = 1), hemorrhage or hematuria (n = 5), and infarction of blood vessel of lower limbs (n = 2). During the follow-up, no patients died for this reason, although tumor recurrence (n = 4, 1.8%) and metastasis (n = 3, 1.4%) were noted.

CONCLUSION

NSS is a safe and effective method to treat carefully selected RCC patients.