OBJECTIVES: To study the short and intermediate surgical, renal functional, and oncologic outcomes of multiplex partial nephrectomy (mPN) and standard partial nephrectomy (sPN) in the setting of a solitary kidney. PATIENTS AND METHODS: Review of a prospectively maintained database of patients undergoing solitary kidney partial nephrectomy at our institution was performed. Patients were stratified into 2 cohorts: mPN-where 3 or more renal tumors were resected and sPN-where 1 or 2 tumors were resected. Perioperative, renal functional, and oncological outcomes were compared. RESULTS: Ninety-three patients with a solitary kidney underwent a total of 121 surgical procedures; 43 (35.5%) were sPN and 78 (64.4%) were mPN. The total and major (Clavien Grade III and IV) complication rates between sPN and mPN were similar (57.1% vs. 70.1%, P = 0.2; 31.0% vs. 35.1%, P = 0.3). At 12 months post-op, the percentage of patients with eGFR > 45 was similar in each group (sPN 87.0%, mPN 73.7%; P = 0.2), and long-term hemodialysis rates were 4.7% and 6.4%, respectively. Completion nephrectomy was performed in 2.3% of sPN and 2.6% of mPN. At a median follow-up of 40.1 months, the metastasis rate was 8.6% in the sPN group and 4.1% in the mPN group (P = 0.4). CONCLUSIONS: Partial nephrectomy in the setting of a solitary kidney can effectively preserve renal function. The renal functional and oncologic outcomes were similar in sPN and mPN, with low hemodialysis rates and complication rates within the expected range of these operations. Three or more tumors in a solitary kidney should not be a contraindication for nephron sparing surgery. Published by Elsevier Inc.
OBJECTIVES: To study the short and intermediate surgical, renal functional, and oncologic outcomes of multiplex partial nephrectomy (mPN) and standard partial nephrectomy (sPN) in the setting of a solitary kidney. PATIENTS AND METHODS: Review of a prospectively maintained database of patients undergoing solitary kidney partial nephrectomy at our institution was performed. Patients were stratified into 2 cohorts: mPN-where 3 or more renal tumors were resected and sPN-where 1 or 2 tumors were resected. Perioperative, renal functional, and oncological outcomes were compared. RESULTS: Ninety-three patients with a solitary kidney underwent a total of 121 surgical procedures; 43 (35.5%) were sPN and 78 (64.4%) were mPN. The total and major (Clavien Grade III and IV) complication rates between sPN and mPN were similar (57.1% vs. 70.1%, P = 0.2; 31.0% vs. 35.1%, P = 0.3). At 12 months post-op, the percentage of patients with eGFR > 45 was similar in each group (sPN 87.0%, mPN 73.7%; P = 0.2), and long-term hemodialysis rates were 4.7% and 6.4%, respectively. Completion nephrectomy was performed in 2.3% of sPN and 2.6% of mPN. At a median follow-up of 40.1 months, the metastasis rate was 8.6% in the sPN group and 4.1% in the mPN group (P = 0.4). CONCLUSIONS: Partial nephrectomy in the setting of a solitary kidney can effectively preserve renal function. The renal functional and oncologic outcomes were similar in sPN and mPN, with low hemodialysis rates and complication rates within the expected range of these operations. Three or more tumors in a solitary kidney should not be a contraindication for nephron sparing surgery. Published by Elsevier Inc.
Authors: R Houston Thompson; Igor Frank; Christine M Lohse; Ismail R Saad; Amr Fergany; Horst Zincke; Bradley C Leibovich; Michael L Blute; Andrew C Novick Journal: J Urol Date: 2007-02 Impact factor: 7.450
Authors: Matthew J Maurice; Daniel Ramirez; Ryan J Nelson; Peter A Caputo; Önder Kara; Ercan Malkoç; Jihad H Kaouk Journal: J Endourol Date: 2016-10-03 Impact factor: 2.942
Authors: Patricia A Parker; Richard Swartz; Bryan Fellman; Diana Urbauer; Yisheng Li; Louis L Pisters; Charles J Rosser; Christopher G Wood; Surena F Matin Journal: J Urol Date: 2012-01-15 Impact factor: 7.450
Authors: Ephrem O Olweny; Samuel K Park; Yung K Tan; Sara L Best; Clayton Trimmer; Jeffrey A Cadeddu Journal: Eur Urol Date: 2012-01-10 Impact factor: 20.096
Authors: R Houston Thompson; Tom Atwell; Grant Schmit; Christine M Lohse; A Nicholas Kurup; Adam Weisbrod; Sarah P Psutka; Suzanne B Stewart; Matthew R Callstrom; John C Cheville; Stephen A Boorjian; Bradley C Leibovich Journal: Eur Urol Date: 2014-08-06 Impact factor: 20.096
Authors: Bimal Bhindi; Ross J Mason; Mustafa M Haddad; Stephen A Boorjian; Bradley C Leibovich; Thomas D Atwell; Adam J Weisbrod; Grant D Schmit; R Houston Thompson Journal: Eur Urol Date: 2017-09-28 Impact factor: 20.096
Authors: Ryan A Hankins; Annerleim Walton-Diaz; Hong Truong; Joanna Shih; Gennady Bratslavsky; Peter A Pinto; W Marston Linehan; Adam R Metwalli Journal: Int Urol Nephrol Date: 2016-08-11 Impact factor: 2.370
Authors: Martin Lang; Cathy D Vocke; Christopher J Ricketts; Adam R Metwalli; Mark W Ball; Laura S Schmidt; William M Linehan Journal: Urology Date: 2020-11-24 Impact factor: 2.649
Authors: Daniel M Geynisman; Jodi K Maranchie; Mark W Ball; Gennady Bratslavsky; Eric A Singer Journal: Urol Oncol Date: 2021-06-04 Impact factor: 2.954