Evaluation of surgical outcomes of nephron-sparing surgery in a leading hospital of an advanced nation

Authors

  • Nadeem Bin Nusrat Department of Urology, University Hospital Galway, Galway, Ireland
  • Kilian Walsh Department of Urology, University Hospital Galway, Galway, Ireland
  • Frank Darcy Department of Urology, University Hospital Galway, Galway, Ireland
  • Garrett Durkan Department of Urology, University Hospital Galway, Galway, Ireland
  • Asadullah Aslam Department of Urology, Letterkenny University Hospital, Donegal, Ireland
  • Saira Imtiaz Pakistan Kidney and Liver Institute and Research Center, Lahore, Pakistan

DOI:

https://doi.org/10.47391/JPMA.11367

Keywords:

Nephron Sparing Surgery, Partial nephrectomy, Small renal masses, Renal score, Perioperative outcomes

Abstract

Objectives: To assess the efficacy of renal score grading in guiding therapy decisions, predicting perioperative outcomes, and characterising tumours following partial nephrectomy.

Methods: The retrospective, single-centre study was conducted at the University College Hospital Galway, Ireland, and comprised data from January 11, 2012, to June 17, 2016, of all patients aged >18 years who underwent partial nephrectomy as part of treatment for kidney cancer. Data was analysed using SPSS 20.

Results: Of the 76 patients, 52(68.4%) were males and 24(31.6%) were females. The median age of patients was 58 years (IQR: 16). Tumours were predominantly on the right side 44(57.9%) and lower pole 36(47.4%), with a median tumour size of 2.35 cm (IQR: 1.0 cm), and renal score had a median of 5.00 (IQR: 2). Of the total, 70(92.1%) patients underwent open surgery, with complications in 6(7.9%), which were associated significantly with higher body mass index, American Society of Anaesthesiologists classification score, warm ischemia time and tumour size (p<0.05). Recurrence correlated with tumour size and positive margins (p<0.05). Survival analysis showed a median disease-free survival (DFS) of 30 months (IQR: 6 months). However, due to the absence of events, the median overall survival (OS) and survival estimates could not be fully calculated. The longest follow-up time was 36 months, with no recorded mortality in the cohort.

Conclusion: For individuals with comparatively small localised renal tumours, the selection of partial nephrectomy was found to be a suitable alternative, showcasing exceptional results regarding the complication profile, recurrence-free survival and overall survival.

Key Words: Nephron Sparing surgery, Partial nephrectomy, Small renal masses, Renal score, Perioperative outcomes.

Published

2024-12-23

How to Cite

Nusrat, N. B., Walsh, K., Frank Darcy, Garrett Durkan, Asadullah Aslam, & Imtiaz, S. (2024). Evaluation of surgical outcomes of nephron-sparing surgery in a leading hospital of an advanced nation. Journal of the Pakistan Medical Association, 75(1), 56–60. https://doi.org/10.47391/JPMA.11367

Issue

Section

RESEARCH ARTICLE