Urology Division, University of São Paulo Medical School, São Paulo, Brazil.
Int Braz J Urol. 2012 May-Jun;38(3):356-61. doi: 10.1590/s1677-55382012000300008.
Partial nephrectomy for small kidney tumors has increased in the last decades, and the approach to non-palpable endophytic tumors became a challenge, with larger chances of positive margins or complications. The aim of this study is to describe an alternative nephron-sparing approach for small endophytic kidney tumors through anatrophic nephrotomy.
A retrospective analysis of patients undergoing partial nephrectomy at our institution was performed and the subjects with endophytic tumors treated with anatrophic nephrotomy were identified. Patient demographics, perioperative outcomes and oncological results were evaluated.
Among the partial nephrectomies performed for intraparenchymal tumors between 06/2006 and 06/2010, ten patients were submitted to anatrophic nephrotomy. The mean patient age was 42 yrs, and the mean tumor size was 2.3 cm. Mean warm ischemia time was 22.4 min and the histopathological analysis showed 80% of clear cell carcinomas. At a mean follow-up of 36 months, no significant creatinine changes or local or systemic recurrences were observed.
The operative technique described is a safe and effective nephron-sparing option for complete removal of endophytic renal tumors.
在过去几十年中，小肾肿瘤的部分切除术有所增加，对于非触诊性内生性肿瘤的处理方法成为了一个挑战，其阳性边缘或并发症的几率更大。本研究旨在通过肾实质切开术来描述一种治疗小的内生性肾肿瘤的替代保肾方法。
对我院行部分肾切除术的患者进行回顾性分析，并确定了采用肾实质切开术治疗内生性肿瘤的患者。评估了患者的人口统计学、围手术期结果和肿瘤学结果。
在 2006 年 6 月至 2010 年 6 月期间，为 10 名内生性肿瘤患者行肾实质切开术。患者的平均年龄为 42 岁，肿瘤平均大小为 2.3cm。平均热缺血时间为 22.4 分钟，组织病理学分析显示 80%为透明细胞癌。平均随访 36 个月后，未观察到明显的肌酐变化或局部或全身复发。
所描述的手术技术是一种安全有效的保肾选择，可完全切除内生性肾肿瘤。
