Protective partial nephrectomy in patients with renal cell carcinoma

One of the major problems in oncourology nowadays is renal cell carcinoma (RCC). For the past few decades its incidence is continuously rising and development of a new innovative technique of RCC treatment is needed. Partial nephrectomy using preventive haemostatic suture is one of such techniques. Aim: Aim of the study is to demonstrate the benefit of using preventive haemostatic sutures in nephron-sparing surgery (NSS). Material and Methods: A total of 113 nephron-sparing surgeries (NSS) using preventive haemostatic sutures in patients with RCC were performed in Urological Department in Botkin State Memorial Hospital, Moscow between 2013 and 2015. 7,8% of the patients submitted to partial nephrectomy had absolute indications, the rest 91,2% - relative indications. In 47 patients the tumor was localized in middle segment, 36 - in upper pole, 30 - lower pole of the kidney. T1a tumor stage was confirmed in 57 patients, T1b confirmed in 39, T2a in 2 and 15 patients had Bosnaik IV renal cysts (containing soft-tissue component). Results: All patients were submitted to NSS using preventive haemostatic sutures. Mean operative blood loss was 100±20 ml. Mean hemoglobin level was 114±10 g/l, mean serum creatinine and urea levels postoperatively was 86±15 pmol/L and 5.4±2 mmol/L accordingly. Mean inpatient hospital stay after surgery was 7±2 days. Conclusion: In this study we demonstrated that NSS using preventive haemostatic suture is suitable for patients with almost any tumor localization and contributes to reduction of number of radical nephrectomies, leading to better RCC treatment results.