ROLE OF OPEN PARTIAL NEPHRECTOMY IN MINIMALLY INVASIVE SURGERY ERA

Abstract

INTRODUCTION

With the aim of preserving maximum renal function, partial nephrectomy (PN) or Nephron Sparing Surgery (NSS) appears to be a logical choice for the management of renal cell carcinoma (RCC). We here report our experience of (Open Partial Nephrectomy) OPN.

MATERIAL AND METHODS

This is a retrospective, single institution study. We included 33 patients who underwent open partial nephrectomy from January 2017 to June 2019. Renal tumours were scored using the R.E.N.A.L nephrometry score (NS). Outcomes included patient demographic data, comorbidities, histological subtype, blood loss, ischemia time complication rate, and 5-year overall survival (OS), etc were analysed and reported.

RESULTS

We report a case-cohort of 33 cases who underwent OPN. The Average age of patients was 48 years (Range 29-74 years). The Most common clinical presentation was incidentally detected renal mass (22), followed by flank pain (6). The median size of the tumour was 3.6cm (1.1 – 7.4).  The most common location of Tumour was the Lower pole (14), followed by the upper pole (11) and the remaining were interpolar (8). T1aN0M0 Clinical Stage was the most common stage found during evaluation followed by T1bN0M0. Final Histopathological Diagnosis was - Clear cell RCC was diagnosed in 20 cases, type 1 papillary RCC in 5 cases, type 2 papillary RCC in 1 case, chromophobe RCC in 2 cases and oncocytoma in 3 cases. During a median follow-up period of 36-60 months, disease recurrence was observed in 1 case, at the local site, One patient had liver metastasis on

follow-up (36 months). The 5-year overall survival rate was 93.9%.

CONCLUSION

Our data demonstrate that OPN is still a viable option with excellent oncological and functional outcomes in simple as well as complex renal tumours in the minimally invasive surgery era.