Our Experience in Conservative Treatment

Abstract

From January 1983 to September 1992 conservative surgery was performed for renal tumors in 29 patients with renal cell carcinoma; bilateral neoplasia (8 patients), anatomical or functional solitary kidney (13 patients) and 8 patients with a contralateral healthy kidney (small, incidental, unique renale neoplasm). We performed partial nephrectomy with excision of a margin of normal tissue for oncological safety rather than enucleation. In our series we especially studied renal function by radionuclide imaging, in those with a follow-up of over 12 months. 23 patients are alive with stable renal function and no evidence of malignancy. Recently we have tried to utilize flow cytometry as an intra-operative test to obtain the result of this test at the same time as the intra-operative pathological examination, so as to have more elements for deciding on conservative surgery. Pre-intra-operative cytometric knowledge could be the new criterion for a well-considered decision between radical or conservative procedures.