Nephron Sparing Surgery for Small Renal Mass at a University Teaching Hospital: A Six Years Retrospective Review

Abstract

IntroductionNephron-sparing surgery (NSS) is the standard of care for clinical T1 (cT1), renal mass less than 7 cm, wheneverintervention is indicated. It has oncological outcome equivalent to radical nephrectomy in small renal massesand it also minimizes the progression to chronic kidney disease. However, there is paucity of data on outcomesof NSS in Nepalese population.MethodsA six years retrospective review of medical records of patients undergoing partial nephrectomy from Jan 2012 toDec 2017 in Department of Urology and Kidney Transplant Surgery at Tribhuvan University Teaching Hospital wasdone to determine its demographics and outcomes.ResultsTwenty eight patients underwent nephron sparing surgery for clinical T1 renal masses in the past six years.Complications occurred in three cases. Five of the lesions were benign and 23 malignant on final histology. Clearcell carcinoma was the commonest variant of renal cell cancer. Margin was positive in two cases and both werekept in close surveillance. There was no local recurrence and renal impairment during five to 60 months followup.ConclusionNephron sparing surgery is a safe procedure with good oncological outcome for clinical T1 renal mass. It preventsunnecessary nephrectomy in benign lesions as well as chronic renal impairment at the same time.KeywordsNephron sparing surgery, small renal mass