Short-term functional and oncological outcomes of partial nephrectomy for renal cell carcinoma in patients with an anatomically or functionally solitary kidney: single-center experience.
BACKGROUND
We retrospectively investigated short-term functional and oncological outcomes of partial nephrectomy (PN) for the anatomically or functionally solitary kidney in patients with renal cell carcinoma.


METHODS
Between 1993 and 2011, 193 partial nephrectomies were performed and 16 (8.3 %) had an imperative indication in our institution. The patients' characteristics, peri- and postoperative complications, surgical margin status and postoperative changes in estimated glomerular filtration rates (eGFR) were assessed.


RESULTS
The median follow-up period was 31.2 months and median age was 69.5 years. Open and laparoscopic PN were performed for 13 and 2 patients, respectively. One patient received ex-vivo PN followed by autotransplantation. There was no case with a positive surgical margin. All patients survived at the final day of observation. Median preoperative eGFR was 48.67 mL/min/1.73 m(2) and the reduction rate of eGFR at 3 months after operation was 20.9 % (0-50.2). Three patients (18.8 %) required temporary hemodialysis after operation and all these patients had stage 4 chronic kidney disease (CKD) before operation. Only one patient needed chronic hemodialysis at 8 months after operation.


CONCLUSIONS
PN can be performed safely and provides feasible functional and oncological outcomes. Preoperative CKD stage 4 patients may have a risk of temporary hemodialysis in the perioperative period.
Department of Urology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
Takeshi
T
Maehana
Toshiaki
T
Tanaka
Hiroshi
H
Kitamura
Naoya
N
Masumori
Taiji
T
Tsukamoto
D058186:Acute Kidney Injury / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000002:abnormalities / Q000473:pathology; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014564:Urogenital Abnormalities / Q000473:pathology