Evaluation of surgical outcomes of nephron-sparing surgery in a leading hospital of an advanced nation.

IF 0.8 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Journal of the Pakistan Medical Association Pub Date : 2025-01-01 DOI:10.47391/JPMA.11367

Nadeem Bin Nusrat, Kilian Walsh, Frank Darcy, Garrett Durkan, Asadullah Aslam, Saira Imtiaz

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引用次数: 0

Abstract

Objective: To assess the efficacy of renal score grading in guiding therapy decisions, predicting perioperative outcomes, and characterising tumours following partial nephrectomy.

Methods: The retrospective, single-centre study was conducted at the University College Hospital Galway, Ireland, and comprised data from January 11, 2012, to June 17, 2016, of all patients aged >18 years who underwent partial nephrectomy as part of treatment for kidney cancer. Data was analysed using SPSS 20.

Results: Of the 76 patients, 52(68.4%) were males and 24(31.6%) were females. The median age of patients was 58 years (IQR: 16). Tumours were predominantly on the right side 44(57.9%) and lower pole 36(47.4%), with a median tumour size of 2.35 cm (IQR: 1.0 cm), and renal score had a median of 5.00 (IQR: 2). Of the total, 70(92.1%) patients underwent open surgery, with complications in 6(7.9%), which were associated significantly with higher body mass index, American Society of Anaesthesiologists classification score, warm ischaemia time and tumour size (p<0.05). Recurrence correlated with tumour size and positive margins (p<0.05). Survival analysis showed a median diseasefree survival (DFS) of 30 months (IQR: 6 months). However, due to the absence of events, the median overall survival (OS) and survival estimates could not be fully calculated. The longest follow-up time was 36 months, with no recorded mortality in the cohort.

Conclusions: For individuals with comparatively small localised renal tumours, the selection of partial nephrectomy was found to be a suitable alternative, showcasing exceptional results regarding the complication profile, recurrencefree survival and overall survival.

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先进国家一流医院肾保留手术疗效评价。

目的：评估肾评分分级在指导治疗决策、预测围手术期预后和部分肾切除术后肿瘤特征方面的疗效。方法：回顾性、单中心研究在爱尔兰戈尔韦大学学院医院进行，数据来自2012年1月11日至2016年6月17日，所有年龄在bb0 - 18岁之间接受部分肾切除术作为肾癌治疗一部分的患者。数据采用SPSS 20进行分析。结果：76例患者中，男性52例（68.4%），女性24例（31.6%）。患者的中位年龄为58岁（IQR: 16）。肿瘤主要位于右侧44例（57.9%），下极36例（47.4%），肿瘤中位大小为2.35 cm (IQR: 1.0 cm)，肾脏评分中位为5.00 （IQR: 2）。其中70例（92.1%）患者行开放手术，6例（7.9%）患者出现并发症，并发症与较高的体重指数、美国麻醉学会分级评分、热缺血时间和肿瘤大小相关(p)。对于相对较小的局部肾肿瘤患者，选择部分肾切除术是一种合适的选择，在并发症、无复发生存期和总生存期方面显示出特殊的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Pakistan Medical Association Medicine-General Medicine

CiteScore

1.10

自引率

11.10%

发文量

983

审稿时长

3-6 weeks

期刊介绍： Primarily being a medical journal, JPMA publishes scholarly research focusing on the various fields in the areas of health and medical education. It publishes original research describing recent advances in health particularly clinical studies, clinical trials, assessments of pathogens of diagnostic importance, medical genetics and epidemiological studies. Review articles highlighting importance of various issues in the domain of public health, drug research and medical education are also accepted. As a leading journal of South Asia, JPMA remains cognizant of the recent advances in the rapidly growing fields of biomedical sciences, it invites and encourages scholars to write short reviews and invited editorials on the emerging issues. We particularly aim to promote health standards of developing countries by encouraging manuscript submissions on issues affecting the public health and health delivery services.