AÇIK PARSİYEL NEFREKTOMİ SONUÇLARIMIZ: 5 YILLIK KLİNİK DENEYİM

Öz

Böbrek tümörleri erişkin tümörlerinin % 3’ünü oluşturmaktadır. Günümüzde yaygın olarak kullanılan ultrasonografi US , bilgisayarlı tomografi BT , manyetik rezonans görüntüleme MRG gibi radyolojik tetkikler sayesinde böbrek tümörleri erken evrelerde ve küçük boyutlarda saptanabilmektedir. Küçük tümörlerde nefron koruyucu cerrahi radikal nefrektomiye denk onkolojik sonuçları ile standart bir yöntem haline gelmiştir. Bu çalışmada kliniğimizde 5 yıl boyunca açık parsiyel nefrektomi yapılan 39 hasta değerlendirildi. Hastaların çoğunda renal kitle non-spesifik şikayetler ile yapılan tetkikler sonucunda saptandı. Patolojik incelemede 9 hastada benign tümör saptandı. Malign tümörler arasında en sık berrak hücreli karsinom saptandı. Tüm hastalarda cerrahi sınır negatifdi. Komplikasyon olarak en sık transfüzyon gerektiren kanama ve ateş saptandı. Açık parsiyel nefrektomi özellikle küçük renal kitle varlığında uygun hastalarda güvenle uygulanabilen etkili bir cerrahi seçenektir

Anahtar Kelimeler

• böbrek tümörü,parsiyel nefrektomi,nefron koruyucu cerrahi

OUTCOMES OF OPEN PARTIAL NEPHRECTOMY: 5 YEAR CLINICAL EXPERINCE

Öz

Kidney tumors comprise 3% of adult tumors. Nowadays, renal tumors can be detected in early stage and small size due to widely used ultrasonography US , computed tomography CT , magnetic resonance imaging MRI as radiological examinations. Nephron-sparing surgery has become a standard method with equal oncologic outcomes with radical nephrectomy in small size tumors. In this study, 39 patients who underwent open partial nephrectom for 5 years were evaluated. Renal mass was detected as a result of examination carried out by non-specific complaints in most of patients. Pathological examination revealed a benign tumor in 9 patients. Most commonly detected tumor was clear cell carcinoma. Surgical margins were negative in all patients. The most frequent complications was bleeding requiring transfusion and fever. Open partial nephrectomy is particularly effective surgical options that can be performed safely in appropriate patients with small renal mass

Anahtar Kelimeler

• kidney tumor,partial nephrectomy,nephron sparing surgery

Kaynakça

1. ) Lindblad P. Epidemiology of renal cell carcinoma. Scand J Surg. 2004; 93(2): 88-96.
2. ) European Network of Cancer Registries. Eurocim version 4.0. European incidence database V2.3, entity dictionary (2001), Lyon, 2001.
3. ) Kural AR, Demirkesen O, Önal B, Öbek C, Tunç B, Önder AU, et al. Outcome of nephron-sparing surgery: elective versus imperative indications. Urol Int. 2003; 71(2): 190-6.
4. ) Volpe A, Panzarella T, Rendon RA, Haider MA, Kondylis FI, Jewett MA. The natural history of incidentally Cancer. 2004; 100(4): 738-45.
5. ) Fergany AF, Hafez KS, Novick AC. Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urol. 2000; 163(2): 442-5.
6. ) Leibovich BC, Blute ML, Cheville JC et al. Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. J Urol. 2004; 171(3): 1066-70.
7. ) Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DY, Uzzo RG. The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. J Urol. 2006; (2): 425-31.
8. ) Gill IS, Kavoussi LR, Lane BR, Blute ML, Babineau D, Colombo JR Jr, et al. Comparison of ,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol. 2007; 178(1): 41-6.

9. ) McKiernan J, Yossepowitch O, Kattan MW, Simmons R, Motzer RJ, Reuter VE, et al. Partial nephrectomy for renal cortical tumors: pathologic findings and impact on outcome. Urology. 2002; (6): 1003-9.
10. ) Remzi M, Özsoy M, Klingler HC, Susani M, Waldert M, Seitz C, et al. Are small renal tumors harmless? Analysis of histopathological features according to tumors 4 cm or less in diameter. J Urol. 2006; 176(3): 896-9.
11. ) Kwon EO, Carver BS, Snyder ME, Russo P. Impact of positive surgical margins in patients undergoing partial nephrectomy for renal cortical tumours. BJU Int. 2007; 99(2): 286-9.
12. ) Nadu A, Kitrey N, Mor Y, Golomb J, Ramon J. Laparoscopic partial nephrectomy: is it advantageous and safe to clamp the renal artery? Urology. 2005; 66(2): 279-82.
13. ) Uzzo RG, Novick AC. Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol. 2001; 166(1): 6-18.