title: Anatrophic nephrotomy as nephron-sparing approach for complete removal of intraparenchymal renal tumors.
abstract: OBJECTIVE
  Partial nephrectomy for small kidney tumors has increased in the last decades, and the approach to non-palpable endophytic tumors became a challenge, with larger chances of positive margins or complications. The aim of this study is to describe an alternative nephron-sparing approach for small endophytic kidney tumors through anatrophic nephrotomy.
  
  
  METHODS
  A retrospective analysis of patients undergoing partial nephrectomy at our institution was performed and the subjects with endophytic tumors treated with anatrophic nephrotomy were identified. Patient demographics, perioperative outcomes and oncological results were evaluated.
  
  
  RESULTS
  Among the partial nephrectomies performed for intraparenchymal tumors between 06/2006 and 06/2010, ten patients were submitted to anatrophic nephrotomy. The mean patient age was 42 yrs, and the mean tumor size was 2.3 cm. Mean warm ischemia time was 22.4 min and the histopathological analysis showed 80% of clear cell carcinomas. At a mean follow-up of 36 months, no significant creatinine changes or local or systemic recurrences were observed.
  
  
  CONCLUSIONS
  The operative technique described is a safe and effective nephron-sparing option for complete removal of endophytic renal tumors.
authors: Urology Division, University of São Paulo Medical School, São Paulo, Brazil. marcosdallogliouro@terra.com.br
authors: Marcos F
authors: MF
authors: Dall'Oglio
authors: Lucas
authors: L
authors: Ballarotti
authors: Carlo C
authors: CC
authors: Passerotti
authors: Davi V
authors: DV
authors: Paluello
authors: Jose Roberto
authors: JR
authors: Colombo
authors: Alexandre
authors: A
authors: Crippa
authors: Miguel
authors: M
authors: Srougi
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009399:Nephrons / Q000601:surgery*; D059351:Organ Sparing Treatments / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden; D052096:Warm Ischemia