Poster session 4: Benign and Malignant renal diseases and Kidney transplant| Volume 8, ISSUE 8, P675, September 2009

C51 Nephron sparing surgery for renal cancer – expanding indications and advancement in minimal invasive surgery

      Introduction and Objectives

      A program for the nephron sparing treatment of kidney tumours was established at our institution in January 1992, laparoscopic approach is used since September 2004. As of June 2009, 302 open resection and 68 laparoscopic resection have been accomplished.

      Material and Methods

      Since 1992 to June 2009 1340 patients were treated for renal tumours, 370 (27.6 %) underwent tumour's resection.


      Nephron sparing surgery composed approximately 23.5±11.8 % per a year. It was 8.0 % in 1992, 25.5 % in 2000 and 40.3 % in 2008. There is so higher application of nephron sparing surgery and lower in nephrectomy, regress equation for nephrectomy: y = -0.02x + 0.9552 vs. y = 0.02x + 0.0448 for resections; reliability value 0.8123. We did not find any statistical significant differences in operation time (mean 115±28 min), but there is a higher application of category T1b (0 % in 1992 vs. 22.7 % in 2000 vs. 32.3 % in 2008). We provided only open surgery for T1b.


      Way to relatively good results of nephron sparing surgery is in careful selection of tumours using two phase CTA and superspecialisation of surgeon. OR still remains gold standard in nephron sparing surgery maily in bigger tumours. The work was supported by Czech government research project MSM 0021620819.