Synchronous resections of intra-abdominal pathologies during radical nephrectomy. A case-linked cohort study evaluation of outcomes.
OBJECTIVE
We report the outcomes of radical nephrectomy with synchronous surgical resection of intra-abdominal pathologies to guide practice.


METHODS
The data of patients requiring radical nephrectomy and surgical resection of a synchronous intra-abdominal pathology over a period of 12 years was extracted on pre-designed data extraction sheets from the case notes and included: age, sex, nature of second intra-abdominal pathology, intra-operative and postoperative details including complications, recurrence rate and survival on follow-up.


RESULTS
Two hundred and ninety patients underwent radical nephrectomy for non-metastatic renal cell carcinoma between January 1995 and January 2007. Amongst these, 30 patients (12%) had an additional surgical resection of a second intra-abdominal pathology at the time of radical nephrectomy. Fifteen underwent radical nephrectomy and surgical resection of a second intra-abdominal non-urological malignancy: colonic tumour - 8, rectal tumour - 3, oesophageal tumour - 2 and gastric tumour - 2. Fifteen patients underwent radical nephrectomy and surgical resection of a synchronous benign intra-abdominal pathology: gall bladder - 8, spleen - 3, uterine fibroid - 1, abdominal aortic aneurysm - 1, colonic polyp - 1 and suspected tumour infiltration of colon - 1. There was a higher morbidity (40%) of radical nephrectomy with synchronous resection of an additional intra-abdominal pathology as compared to radical nephrectomy alone group (25%); however it not was statistically significant (P-value 0.275).


CONCLUSIONS
It is feasible to offer simultaneous resection of synchronous intra-abdominal pathologies with renal cell carcinoma patients undergoing radical nephrectomy, albeit, at a higher morbidity.
Somani
B K
BK
Department of Urology, Aberdeen Royal Infirmary Hospital, Grampian Health Board, Aberdeen, Scotland, UK.
Nicol
G
G
Bhavan
R
R
Swami
S
S
Nabi
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000706:statistics & numerical data*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D016896:Treatment Outcome