Partial nephrectomy using preventive hemostatic sutures in renal cell carcinoma patients
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Abstract
Objective. To improve the treatment results of renal cell carcinoma patients using preventive hemostatic suture. Material and methods. Our study included 113 patients with renal cell carcinoma pT1a-T2b N0M0. Tumor was localized in the middle segment in 47 patients, in the lower pole - in 36, and in the upper pole - in 30. T1a tumor stage was verified in 57 patients, T1b stage - in 39, T2a - in 2, and 15 patients had Bosniak IV stage cysts. 9 patients (8%) had absolute indications for the operation, the rest 104 (92%) had relative indications. Results. All patients underwent partial nephrectomy. Mean surgery time was 180 ± 40 min, mean anesthesia time - 190.5 ± 15 min, mean blood loss - 100 ±20 ml. There were neither complications during the surgery, nor conversion to nephrectomy. We used dynamic renal scintigraphy tests to evaluate kidney function before and after operation: mean perfusion index was 54.13 ± 2 and 45.23 ± 3% respectively, mean renal index - 53.24 ± 4 and 44.82 ± 2.39%, glomerular filtration rates - 33.84 ± 2 and 25.84 ± 1.7 ml/min. Conclusion. The use of preventive hemostatic suture allows to perform partial nephrectomy in renal cell carcinoma patients with any tumor location without clamping the vascular pedicle, and to protect the rest kidney parenchyma from ischemia and necrosis.
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