THE RESULTS OF NEPHRON-SPARING SURGERY OF RENAL TUMORS WITH THE IMPERATIVE INDICATIONS

Khareba G. G., Lisovyi V. M., Shchukin D. V., Demchenko V. M.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The purpose of the study was to investigate the results of nephron-sparing surgery for renal tumors in patients with imperative indications for surgery. The results were obtained on the basis of analyzing nephron sparing treatment of 701 patients with renal tuWe selected patients who had absolute indications for kidney preservation and conducted a comparative evaluation of treatment results with the patients who had relative and elective indications for nephron-sparing surgery. We evaluated the clinical and morphological parameters of neoplasms and patients, intraoperative features, the level of intra- and perioperative complications, as well as long-term oncological results of treatment. The results of analysis showed that the absolute indications for nephron-sparing surgery had 167 (23.8%) patients, among them there were 33 (4.7%) patients with a single (anatomically or functionally) kidney, 21 (3.0%) patients with bilateral renal tumors, and 137 (19.5%) cases of renal failure (GFR <60 ml/min). 22 (3.1%) patients had a combination of two imperative indications, which certainly required the use of nephron-sparing surgery. The remaining 534 (76.2%) patients had relative and elective indications for nephron-sparing surgery. Intra- and postoperative complications in percentage were significantly higher among patients with absolute indications for kidney preservation (p <0.001). Overall and cancer-specific mortality was significantly higher among patients with absolute indications for nephron-sparing surgery (p <0.05). However, no significant difference was found in terms of cancer-nonspecific mortality, the number of local recurrences and metastases. Nephron-sparing surgery is particularly valuable and effective for patients with imperative indications for this type of surgery, which prevents renoprivation, when the transition to hemodialysis is synonymous with a significant reduction in a patient’s quality of life and associated with a significant reduction in patient survival.

nephron-sparing surgery, renal tumors, long-term results.

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«Bulletin of problems biology and medicine» Issue 2 (156), 2020 year, 179-184 pages, index UDK 616.61-006.6-089.87-036.65-08

10.29254/2077-4214-2020-2-156-179-184