Partial nephrectomy safely preserves renal function in patients with a solitary kidney.
OBJECTIVE
We examined the success of partial nephrectomy in a group of patients in whom its role is paramount, namely those with a solitary kidney requiring surgery.


METHODS
We reviewed the records of 84 consecutive patients who underwent partial nephrectomy from January 1995 to August 2000. Of these 84 patients 30 (36%) met our study criteria for an absolute indication for partial nephrectomy, which included namely a solitary kidney or bilateral renal masses for which radical nephrectomy was indicated for at least 1 renal unit. The variables examined included preoperative and postoperative renal function, pathological evaluation, surgical margins, major and minor complication rates, and the need for dialysis.


RESULTS
At a median followup of 24 months (range 1 to 74) median creatinine had increased from 1.5 mg./dl. preoperatively to 1.8 postoperatively. None of the 30 patients required dialysis in the perioperative period. Of the tumors 22 (73%) were renal cell carcinoma and 4 (13%) were oncocytoma. All surgical margins were negative for malignancy and no patient has had local recurrence to date. Eventually but not immediately 2 patients with renal insufficiency preoperatively had progression to end stage renal disease, necessitating dialysis at long-term followup.


CONCLUSIONS
In patients who require partial nephrectomy this procedure can safely preserve renal function and effectively treat malignancy.
Adkins
Kent L
KL
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Chang
Sam S
SS
Cookson
Michael S
MS
Smith
Joseph A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007668:Kidney / Q000502:physiology; D007680:Kidney Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*