[Controversies of partial nephrectomy for renal cell carcinoma : survey in the German-speaking countries].
BACKGROUND
The goal of this study was to evaluate how partial nephrectomy is technically performed in Germany, Austria, and Switzerland.


METHODS
A one-page anonymous questionnaire was designed to evaluate the indication, the technical procedure, and the follow-up of R1 situation after partial nephrectomy. Furthermore, the size of the hospitals and their catchment areas were recorded. The questionnaire was sent to 341 clinics and a statistical analysis was performed.


RESULTS
The response rate was 69 %. Up to 99 % of the clinics also perform partial resection in T1b tumors. Of those responding, 58 % perform this surgery laparoscopically, and 83 % of the surgeries are performed in warm ischemia. For the follow-up, 29 % suggest imaging within the first 6 weeks. According to this survey, maximum care clinics perform laparoscopic nephrectomy more frequently (p = 0.003).


CONCLUSIONS
The survey of 236 hospitals performing partial nephrectomy shows great variability in the indication, technique, and aftercare of organ-preserving renal tumor surgery. It also shows that a large proportion of tumors >4 cm undergo organ-preserving surgery, many of them minimally invasive. The diverse handling with positive instantaneous section and R1 results suggest the need for further studies concerning long-term follow-up after minimally invasive surgery with R1 situation and renal tumors > T1a.
Klinik für Urologie und Andrologie, Klinikum St. Georg gGmbH, Delitzscher Straße 141, 04129, Leipzig, Deutschland, stefan.tietze@sanktgeorg.de.
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S
Tietze
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M
Herms
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W
Behrendt
J
J
Krause
A
A
Hamza
D001317:Austria; D002292:Carcinoma, Renal Cell / Q000453:epidemiology / Q000601:surgery*; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000601:surgery*; D010535:Laparoscopy / Q000706:statistics & numerical data*; D019060:Minimally Invasive Surgical Procedures / Q000706:statistics & numerical data*; D009392:Nephrectomy / Q000706:statistics & numerical data*; D059351:Organ Sparing Treatments / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome