Partial Nephrectomy Versus Radical Nephrectomy for Localized Renal Masses: Critical Analysis of Oncological Outcome and Impact on the Renal Function

Abstract

Background: Management of renal tumors remains a controversial issue especially in small size tumors or special situations as bilateral disease, single kidney, or compromised renal function, nephron-sparing surgery is the case in such situations. Objective: Comparing oncological outcome and impact on renal function of open radical nephrectomy and open partial nephrectomy for management of renal tumors. Patients and methods: Our study was conducted as a non-randomized prospective observational study at the Urology Department, Menoufia University Hospital between December 2018 and June 2020. Forty-eight patients with organ-confined renal masses were included in the study. They were divided into two equal groups; (group 1) 24 patients and was treated by PN, and (group 2) 24 patients and was treated by RN. Results: The mean age of our study is 56.6±13.2. Thirty-two patients were males (66.7%), while females represented 16 (33.3%). Hot ischemia was done for all partial nephrectomy cases with a mean time of ischemia 13.2±4.1. We used different techniques included simple enucleation in 17 patients (70.8%), polar nephrectomy in 4 patients (16.7%), and wedge resection in 3 patients (12.5%). Regarding surgical margin, it was free in 21 patients (87.5%) of PN and positive in 3 patients (12.5%) 2 of them missed follow up and 1 showed no recurrence till now. Our patients showed a smooth postoperative course. Conclusion: Both techniques (RN&PN) were comparable in terms of oncological outcomes. Patients tolerated both techniques with no major complications, however partial nephrectomy is advised in the localized renal tumors when technically feasible with less probability of complications and good follow-up data regarding the renal function, the oncological outcome is the same as radical surgery.