title: [Nephron sparing surgery in renal cell carcinoma: our experience of a 20-year clinical practice].
abstract: OBJECTIVE
  Nephron sparing surgery (NSS) is now considered the standard of care in the treatment of renal cell carcinoma (RCC) in stage T1. We retrospectively evaluated our results related to the use of NSS in over twenty years of clinical practice.
  
  
  METHODS
  We reviewed our database relating to the use of NSS in the last twenty years of clinical practice, from 1988 to July 2012, in 549 patients. The pre- and post-operative parameters recorded are the evaluation of the site and size of the renal lesion obtained from radiological investigations, the need for clamping the renal pedicle, open or laparoscopic surgical approach, blood loss, histology and intra- and postoperative complications. We also evaluated the parameters related to renal function before and after surgery.
  
  
  RESULTS
  The mean follow-up was 95 months (7.6 years). The average diameter of the lesion at CT abdomen was 4.8 cm (1-8 cm). The warm ischemia was required in 317 patients, cold in 18 patients, no need for ischemia in 214 patients. The total duration of surgery was 122.56 ± 52.76 min. 15 procedures were performed laparoscopically. Ischemia time: 3'-25'; bleeding: 50-1000 cc. The lesion was benign in 115 of the 549 patients enrolled; it was a RCC in the remaining cases except for three, which were papillary carcinomas. At 5 years, the cancer free survival rate was 97.5%.
  
  
  CONCLUSIONS
  Our data show that the implementation of NSS offers long-term benefits in terms of functional results and a good cancer control.
authors: Cliniche Humanitas Gavazzeni, Unità Operativa di Urologia, Bergamo - Italy. gianna.pace@gavazeni.it
authors: Gianna
authors: G
authors: Pace
authors: Emanuele
authors: E
authors: Micheli
authors: Sergio
authors: S
authors: Valenti
authors: Giulio
authors: G
authors: Borgonovo
authors: Alberto
authors: A
authors: Vismara
authors: Antonella
authors: A
authors: Tocco
authors: Antonino
authors: A
authors: Lembo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009399:Nephrons; D059351:Organ Sparing Treatments; D012189:Retrospective Studies