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A NOVEL TECHNIQUE OF PARTIAL NEPHRECTOMY: NO ISCHEMIA. IS IT SAFE?
Introdução, Material, Método, Resultados, Discussão e Conclusões
Introduction Partial Nephrectomy is the gold standard treatment for small renal masses. Extraction and suture of renal parenchyma in only 20 minutes of ischemia have been a technique limitation in the current practice.
Aim: Demonstrate a novel technique of partial nephrectomy without vessel clamping using previous stitches under tumor, before ressection.
Method: All procedures were made using laparoscopic approach. Stitches using vicryl 2.0 were made previous to the exeresis of the tumor after correct demarcation of the lesion respecting free margins.
Results: The study counted with 7 patients submitted to partial nephrectomy. Mean age was 63.5 years. Tumor size ranged from 1.7 to 4.8cm. In three patients tumor was located in the lower pole of the kidney, in two patients it was located in the medium portion of the kidney and in the upper pole in the other two patients. Blood loss ranged from 50ml to 1000ml. Mean surgery time was 100min (80 to 180 minutes). Pathological analysis confirmed clean cells tumor in five cases and the other two were oncocytomas. Only one case presented scarce margins, and all the others had free resection margins. All patients were followed for at least one year and did not present any kind of recurrence or progression in imaging control during the follow-up.
Conclusion: Partial nephrectomy without ischemia using previous stitches under lesion is a safe and feasible option in select cases.
PARTIAL; NEPHRECTOMY; ISCHEMIA.
Câncer de Rim
PUC-SP - Sao Paulo - Brasil
Raphael Souza Sanches, Brunno Cezar Framil Sanches, Pedro Henrique Serafim, Lineu Amaro Rodrigues Junior, Daniel Coser Gomes, Auro Cezar Araújo, José Arthur Huffenbacher Coelho Araújo, Júlio José Geminiani, Marcelo Mai Jurado, Leonardo Oliveira Reis