Table of Contents
ISRN Surgery
Volume 2013, Article ID 691080, 6 pages
Clinical Study

Nephron-Sparing Surgery for Renal Masses Measuring Larger Than on Preoperative Imaging: A Single Surgeon, Single Center Experience

1School of Medicine, Koc University, Istanbul 34450, Turkey
2Department of Urology, VKF American Hospital, Istanbul 34365, Turkey
3Department of Radiology, VKF American Hospital, Istanbul 34365, Turkey

Received 21 February 2013; Accepted 20 March 2013

Academic Editors: C. F. Bianchi, D. Galetta, and D. Laub

Copyright © 2013 Tarık Esen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. To document the feasibility of nephron-sparing surgery (NSS) for the surgical treatment of renal masses measuring larger than 7 cm (cT2) on preoperative imaging. Methods. A total of 139 patients have undergone NSS between 2001 and 2012 by a single surgeon in our clinic. Of these, we identified 17 patients whose tumors were measuring greater than 7 cm on preoperative imaging studies and were limited to the kidney. Their charts were retrospectively reviewed. Results. Mean age of the study population was years. Thirteen patients were managed by open NSS, while 4 patients have undergone robot-assisted NSS. Mean diameter and mean R.E.N.A.L. score of the tumors that were enucleoresected were 8.2 cm and 8.5, respectively. A total of 5 Clavien grade 2 and higher complications were recorded within 30 days of surgery. Histopathologic examination revealed benign histology in almost 1/4 of the cases. After a median followup of 33 months, all of our patients were alive. Only one patient (5.8%) experienced local recurrence. Conclusions. NSS is a feasible and safe option for large (>7 cm) renal masses. It may be considered not only for imperative conditions but also for highly selected cases with a normal contralateral kidney.