PARTIAL NEPHRECTOMY

Abstract

In 31 cases that underwent partial nephrectomy during the 10 years period from April 1975 to March 1985, indication of operation, operative technique, postoperative complications and prognosis were reviewed. Among these 31 cases, renal calculi were most prevalent (24 cases or 77.4%). Out of them, 22 cases had multiple calculi in the renal calyx or calyceal diverticulum. The remaining 7 cases consisted of 4 cases of duplex kidney and 1 case each of renal pelvic tumor, renal cell carcinoma, and renal artery aneurysm. Three out of the 31 cases had anatomically or functionally solitary kidney. The most fregeuntly used operative techniques for partial nephrectomy was guillotine resection, which was employed in 20 cases, followed by wedge resection in 7 cases, and heminephrectomy in 4 cases. Renal circulation was arrested in 24 cases, with a mean ischemic time of 35 minutes. Mean operative blood loss was 716ml. Gross hematuria disappeared on the 1st postoperative day in 28 out of the 31 cases. Operative death occurred in none of the cases, nor did any cases require delayed nephrectomy. Postoperative complications were: delyaed renal hemorrhage in 1 case, urinary fistula in 1 case and wound infection in 2 cases. None of the cases showed loss of renal function. Out of 24 cases of renal calculi, calculi remained in 4 cases, in 1 of them new calculi were formed. However, among 20 cases in whom calculi had been removed completely, no recurrence was found in 2 years and 1 month to 10 years after the operation. Two cases of malignant tumor have remained well without recurrence of tumor for 10 years and 2 years and 8 months after operation, respectively. Since partial nephrectomy is a safe and useful surgical intervention, it is valuable enough to use in the treatment of lesions with localized foci which can be cured by resection in a part of the kidney, such as multiple lower calyceal calculi, tumors of solitary kidney or bilateral kidneys.