title: Simple enucleation versus standard partial nephrectomy for clinical T1 renal masses: perioperative outcomes based on a matched-pair comparison of 396 patients (RECORd project).
abstract: OBJECTIVE
  To compare simple enucleation (SE) and standard partial nephrectomy (SPN) in terms of surgical results in a multicenter dataset (RECORd Project).
  
  
  METHODS
  patients treated with nephron sparing surgery (NSS) for clinical T1 renal tumors between January 2009 and January 2011 were evaluated. Overall, 198 patients who underwent SE were retrospectively matched to 198 patients who underwent SPN. The SPN and SE groups were compared regarding intraoperative, early post-operative and pathologic outcome variables. Multivariable analysis was applied to analyze predictors of positive surgical margin (PSM) status.
  
  
  RESULTS
  SE was associated with similar WIT (18 vs 17.8 min), lower intraoperative blood loss (177 vs 221 cc, p = 0.02) and shorter operative time (121 vs 147 min; p < 0.0001). Surgical approach (laparoscopic vs. open), tumor size and type of indication (elective/relative vs absolute) were associated with WIT >20 min. The incidence of PSM was significantly lower in patients treated with SE (1.4% vs 6.9%; p = 0.02). At multivariable analysis, PSM was related to the surgical technique, with a 4.7-fold increased risk of PSM for SPN compared to SE. The incidence of overall, medical and surgical complications was similar between SE and SPN.
  
  
  CONCLUSIONS
  Type of NSS technique (SE vs SPN) adopted has a negligible impact on WIT and postoperative morbidity but SE seems protective against PSM occurrence.
authors: Policlinico Federico II, Università di Napoli, Italy.
authors: N
authors: N
authors: Longo
authors: Clinica Urologica I, AOUC, Università di Firenze, Italy.
authors: A
authors: A
authors: Minervini
authors: Unità Operativa di Urologia Dipartimento di NefroUrologia, Azienda AO Spedali Civili di Brescia, Italy.
authors: A
authors: A
authors: Antonelli
authors: Policlinico di Modena, Clinica Urologica, Università di Modena, Italy.
authors: G
authors: G
authors: Bianchi
authors: Dipartimento Chirurgico Polispecialistico, Urologia, Azienda Ospedaliera Ospedale Riguarda Ca' Granda, Milano, Italy.
authors: A M
authors: AM
authors: Bocciardi
authors: Unità Operativa di Urologia Dipartimento di NefroUrologia, Azienda AO Spedali Civili di Brescia, Italy.
authors: S C
authors: SC
authors: Cunico
authors: Divisione di Urologia, Università di Torino, Ospedale San Luigi Gonzaga, Orbassano, Torino, Italy.
authors: C
authors: C
authors: Fiori
authors: Policlinico Federico II, Università di Napoli, Italy. Electronic address: ferdinando-fusco@libero.it.
authors: F
authors: F
authors: Fusco
authors: Clinica Urologica I, AOUC, Università di Firenze, Italy.
authors: S
authors: S
authors: Giancane
authors: Clinica Urologica I, AOUC, Università di Firenze, Italy.
authors: A
authors: A
authors: Mari
authors: Dipartimento di Urologia, Università di Bologna, Ospedale S. Orsola-Malpighi, Bologna, Italy.
authors: G
authors: G
authors: Martorana
authors: Policlinico Federico II, Università di Napoli, Italy.
authors: V
authors: V
authors: Mirone
authors: LUNA Foundation, Italy.
authors: G
authors: G
authors: Morgia
authors: Clinica Urologica, Università di Padova, Padova, Italy.
authors: G
authors: G
authors: Novara
authors: Divisione di Urologia, Università di Torino, Ospedale San Luigi Gonzaga, Orbassano, Torino, Italy.
authors: F
authors: F
authors: Porpiglia
authors: Department of Pathology, University of Florence, Careggi Hospital, Florence, Italy.
authors: M R
authors: MR
authors: Raspollini
authors: Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Italy.
authors: F
authors: F
authors: Rocco
authors: I.R.C.C.S. Policlinico San Matteo - Struttura Di Urologia, Italy.
authors: B
authors: B
authors: Rovereto
authors: Dipartimento di Urologia, Università di Bologna, Ospedale S. Orsola-Malpighi, Bologna, Italy.
authors: R
authors: R
authors: Schiavina
authors: Clinica Urologica I, AOUC, Università di Firenze, Italy.
authors: S
authors: S
authors: Serni
authors: Unità Operativa di Urologia Dipartimento di NefroUrologia, Azienda AO Spedali Civili di Brescia, Italy.
authors: C
authors: C
authors: Simeone
authors: Policlinico Federico II, Università di Napoli, Italy.
authors: P
authors: P
authors: Verze
authors: Dipartimento di Urologia, Azienda Ospedaliera Maggiore della Carità, Novara, Italy.
authors: A
authors: A
authors: Volpe
authors: Clinica Urologica, Università di Padova, Padova, Italy.
authors: V
authors: V
authors: Ficarra
authors: Clinica Urologica I, AOUC, Università di Firenze, Italy.
authors: M
authors: M
authors: Carini
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D057216:Propensity Score; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Carcinoma; Partial nephrectomy; Pathology; Renal cell; Simple enucleation; Surgical outcome assessment