title: Elective open nephron-sparing surgery for renal masses: single-center experience with 129 consecutive patients.
abstract: OBJECTIVE
  To present our experience with elective, open, nephron-sparing surgery for renal masses in a contemporary, consecutive series.
  
  
  METHODS
  In this retrospective study, the files of all patients who underwent elective nephron-sparing surgery between January 1996 and December 2002 at our institution were reviewed. The preoperative workup included renal ultrasonography and abdominal computed tomography. The histologic findings, complications, and oncologic outcome were studied. The surgical technique (ischemia and regional hypothermia) was identical in all patients.
  
  
  RESULTS
  A total of 129 patients (mean age 61 years) were analyzed. The mean +/- standard deviation tumor size on preoperative computed tomography was 4.0 +/- 2.4 cm. Renal cell carcinoma was present in 86 patients (66.7%), a benign cyst in 18 (13.9%), oncocytoma in 10 (7.8%), angiomyolipoma in 7 (5.5%), adenoma in 4 (3.1%), xanthogranulomatous pyelonephritis in 3 (2.3%), and metastasis of a malignant melanoma in 1 patient. Two patients (1.6%) required secondary nephrectomy because of postoperative bleeding. After a median follow-up of 34 months (range 2 to 91), no patient had developed local recurrence, one (0.8%) had developed lymph node metastasis, and two (1.6%) had developed distant metastases. The creatinine clearance decreased from 77 +/- 27 mL/min before surgery to 64 +/- 23 mL/min after a median of 34 months.
  
  
  CONCLUSIONS
  The results of this contemporary, monocenter experience underline the role of open, elective, nephron-sparing surgery for patients with small renal masses, particularly because benign histologic findings were present in almost one third of patients.
authors.affiliation: Department of Urology, Ludwig Boltzmann Institute for Urological Oncology, Donauspital, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Marszalek
authors.forename: Anton
authors.initials: A
authors.lastname: Ponholzer
authors.forename: Clemens
authors.initials: C
authors.lastname: Brössner
authors.forename: Johann
authors.initials: J
authors.lastname: Wachter
authors.forename: Ulrich
authors.initials: U
authors.lastname: Maier
authors.forename: Stephan
authors.initials: S
authors.lastname: Madersbacher
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018207:Angiomyolipoma / Q000473:pathology / Q000601:surgery; D003250:Constriction; D003404:Creatinine / Q000097:blood; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007036:Hypothermia, Induced; D052177:Kidney Diseases, Cystic / Q000473:pathology / Q000601:surgery*; D007680:Kidney Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011705:Pyelonephritis, Xanthogranulomatous / Q000473:pathology / Q000601:surgery; D012077:Renal Artery; D012189:Retrospective Studies
chemical_list: D003404:Creatinine