Three-dimensional reconstructive kidney volume analyses according to the endophytic degree of tumors during open partial or radical nephrectomy.
OBJECTIVE
To investigate the renal function outcomes and contralateral kidney volume change measured by using a 3-dimensional reconstructive method after open partial nephrectomy (PN) or open radical nephrectomy (RN) according to the endophytic degree of tumors.


METHODS
We included 214 PN and 220 RN patients. According to the endophytic degree of the tumors, we divided patients into 3 groups. Patients were assessed for renal function and kidney volume change both preoperatively and postoperatively at 6 months. Kidney volume was calculated by using personal computer-based software. Subgroup analyses was performed for tumor >4cm.


RESULTS
Larger and complex tumors were more frequent in the RN group than PN group. Among patients with exophytic and mild endophytic tumors, the mean postoperative renal function was well preserved in PN group and the mean contralateral kidney volume significantly increased in the RN compared to the PN group (PN, 145.55 to 149.98mL; 3.0% versus RN, 143.93 to 169.64mL;17.9% p=0.006). However, in fully endophytic tumors, compensatory hypertrophy of the contralateral kidney was similar between PN and RN (PN, 138.16 to 159.64mL; 15.5% versus RN, 138.65 to 168.04mL; 21.2% p=0.416) and renal functional outcomes were similar between both groups. These results were also confirmed in tumors >4cm in size.


CONCLUSIONS
In fully endophytic tumors, especially large tumors, the postoperative renal function and contralateral kidney volume were similar; therefore, we should consider RN preferentially as surgical option for these tumors.
Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Dong Soo
DS
Park
Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Young Kwon
YK
Hong
Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Seung Ryeol
SR
Lee
Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Jin Ho
JH
Hwang
Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Moon Hyung
MH
Kang
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Jong Jin
JJ
Oh
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D007680:Kidney Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009392:Nephrectomy / Q000379:methods*; D009929:Organ Size; D011184:Postoperative Period; D011446:Prospective Studies; D020127:Recovery of Function; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden