Evaluation of Nephron Sparing Surgery in Adults

Abstract

Objective: Evaluation of Nephron Sparing Surgery in Adults. Results: RCC is the third most frequent urological cancer after prostate cancer and bladder cancer. It represents 2-3 % of all cancers, with 2% annual increase in incidence worldwide. Surgery is the only curative procedure, performed as RN or NSS. RN consists of nephrectomy with ipsilateral adrenalectomy and lymphadenectomy, but NSS means resection of the tumor only with 1-3 mm of healthy surrounding tissue and preservation of the rest of the kidney as well as ipsilateral adrenal gland and lymph nodes. NSS is a method of preservation of kidney function with radical resection of localized RCC. NSS is the first choice of surgery for patients with low grade renal tumors. It has excellent oncological results comparable with RN, and also with more preservation of the renal function. NSS historically was restricted to cases of solitary kidney, or bilateral renal tumors. The significantly lower rate of cancer specific deaths compared to RN supports using NSS not only for RCC with tumor size <4cm, but also for tumors >4cm. Conclusion: The current evidences suggest that localized renal cancers are best managed by nephron sparing surgery rather than by radical nephrectomy. Key words: nephron sparing surgery, radical nephrectomy, renal cell carcinoma, renal tumors, laparoscopic nephron sparing surgery.