V9-04: Partial Nephrectomy in Patients with Multiple Renal Lesions Amenable to Nephron Sparing Surgery
VideoIntroductions and Objectives
Nephron sparing surgery is an optimal treatment modality for addressing individuals with bilateral renal masses. Herein, we report on our experience with partial nephrectomy in patients with multiple renal lesions.
A 45 year old female and a 57 year old male were found to have multiple bi-lateral renal masses on diagnostic imaging. They were taken to the operating room (different dates) for a partial nephrectomy of multiple ipislateral renal lesions. Their charts were pulled and retrospectively examined.
The 57 year old male had an operative time 189 minutes, estimated blood loss of 450cc, and an ischemia time of 29 minutes Post-operatively the creatinine was 1.2, length of stay was 2 days, most recent creatinine was 1.0, and pathology showed clear cell type renal cell carcinoma. The 45 year old female had an operative time 193 minutes, estimated blood loss of 375cc, and an ischemia time of 26 minutes. Post-operatively the creatinine was 1.4, length of stay was 2 days, most recent creatinine was 0.9, and pathology showed clear cell type renal cell carcinoma.
Although technically challenging, partial nephrectomy in patients with multiple renal masses is feasible. We suggest addressing the smaller lesions first, deferring renal vessel clamping for small exophytic lesions to reduce ischemia time, and scoring all resected lesions to keep track for pathological review.