Ömer TURANGEZLİ, ŞENOL ADANUR, Tevfik ZİYPAK, HASAN RIZA AYDIN, Turgut YAPANOĞLU, Özkan POLAT

T1 renal kitlelerde açık nefron koruyucu tedavi: Cerrahi, onkolojik ve fonksiyonel sonuçlarımız

Amaç: Böbrek kitlesi tanısı ile T1 klinik evrede olan hastalara uyguladığımız nefron koruyucu cerrahinin cerrahi, onkolojik ve fonksiyonel sonuçlarını sunmayı amaçladık.Gereç ve Yöntemler: 2004 - 2012 tarihleri arasında 7 cm den küçük renal kitle tespit edilip açık nefron koruyucu cerrahi yapılan toplam 36 hasta çalışmamıza dahil edildi. Olguların demografik verileri, lezyonların radyolojik ve patolojik özellikleri ve takip süreleri retrospektif olarak değerlendirildi. Postoperatif takipte lokal nüksü değerlendirmek amacıyla alt üst batın magnetik rezonans görüntüleme metodu kullanıldı.Bulgular: Ortalama yaşları 54 yıl olan 19’u kadın 17’si erkek toplam 36 hastaya açık cerrahi teknik ile retroperitoneal NKC uygulandı. Ortalama tümor çapı 2.9x2.5 cm olarak tesbit edildi. Hastaların 3 %8 ’ünde bilateral renal kitle mevcuttu. iki hastaya operasyon esnasında sıcak iskemi uygulandı. Diğer hastalarda prosedür iskemisiz uygulandı. Hastaların preoperatif kreatinin değerleri ortalaması 0.87 mg/dl iken postoperatif kreatinin değerleri ortalaması 0.96 mg/dl olarak bulundu. Postoperatif kreatinin değerlerindeki artış istatistiksel olarak anlamlı bulunmadı p=0.81 . Sıcak iskemi yapılan 2 hastada da postoperatif kreatinin değerlerinde yükselme izlenmedi.Ortalama takip süresi 39 ay idi. Hiçbir hastada lokal nüks veya uzak metastaz izlenmedi. Hastalığa özgü sağ kalım ve genel sağ kalım oranları %100 olarak tesbit edildi.Sonuç: Açık parsiyel nefrektomi halen en sık olarak uygulanan nefron koruyucu tedavi yöntemidir. Radikal nefrektomi ile benzer onkolojik sonuçlar ve daha az kronik böbrek hastalığı gelişme riski ile uygun klinik evredeki böbrek tümörlerinde güvenle uygulanabilen bir yöntem olarak yerini korumaktadır

Anahtar Kelimeler:

Nefron koruyucu tedavi, Renal kitle

Open nephron-sparing treatment of T1 renal masses: Surgical, oncologic and functional outcomes

Objective: We aimed to present surgical, oncological, and functional outcomes. We aimed to present surgical, oncological and functional outcomes of patients with T1 stage renal tumour which were treated with nephron-sparing surgery.Materials and Methods: A total of 36 patients who had undergone nephron-sparing surgery NSS between 2004, and 2012 for the management of previously identified renal masses of

Keywords:

Nephron sparing surgery, Renal,

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