Background: The standard treatment of small renal lesion is partial nephrectomy with concentration on preservation of renal function by minimizing ischemic time and decreasing surgical complications without residual malignancy.
Objective: To evaluate the outcomes of open partial nephrectomy with manual parenchymal compression plus on demand arterial clamping.
Patient and Methods: Twenty seven patients with renal tumors amenable for partial nephrectomy had been included in the current study. Their ages range from 22-81 years. The lesions were evaluated by 3 dimensional CT scan. Open partial nephrectomy was done using manual compression with on-demand arterial clamping. Patients were followed by 3 monthly ultrasound checking and CT scan at least once for checking of renal dimensions, echogenicity and for recurrence and metastasis. The follow up period ranges between 3-36 months.
Results: Manual compression was an efficient method in control bleeding, except in 3 patients where arterial clamping was required for a mean period of 13 minutes warm ischemia time. Frozen section from the bed was negative in all patients primarily and after re-resection in 4 patients. Final pathology was renal adenocarcinomas, except in 4 patients, where it was benign (one: oncocytoma, two: hydatid cysts and one: inflammatory lesion).
Conclusion: Open partial Nephrectomy with manual parenchymal compression had acceptable outcomes in terms of complete tumor control, reduce warm ischemia time and minimizing bleeding with good preservation of renal function and minimal complications.
International Journal of Advanced Research in Medicine
