Nefrectomía parcial vs enucleación tumoral
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v80i6.709Palabras clave:
cirugía conservadora de nefronas, nefrectomía parcial, enucleación simpleResumen
Antecedentes y objetivo: La cirugía conservadora de nefronas se ha convertido en la técnica quirúrgica estándar para masas renales de pequeño tamaño, desbancando la tradicional nefrectomía radical. El objetivo del estudio es comparar nefrectomía parcial y enucleación tumoral en función de morbilidad y resultados oncológicos.
Material y métodos: Estudio de cohortes retrospectivo de pacientes sometidos a nefrectomía parcial o enucleación en el Hospital Clínico Universitario Lozano Blesa de Zaragoza, entre agosto de 2011 y octubre de 2019. Variables demográficas, clínicas, quirúrgicas y resultados oncológicos han sido analizadas.
Resultados: 48 pacientes fueron seguidos 36.1±28.0 meses. Los pacientes sometidos a enucleación tumoral, respecto al grupo de nefrectomía parcial presentaron valores inferiores de sangrado medio (117.7±95.1 ml y 221±293.1 ml, p=0.488), isquemia (46% y 95%, p<0.001), tiempo de isquemia medio (24.6±7.2 min y 25.1±10.4 min, p=0.844) y complicaciones (11.5% y un 22.7%, p=0.442) respectivamente. No se observó recidiva local.
Conclusiones: Ambos grupos son comparables en cuanto a estadio tumoral, presentando en el grupo de enucleación un menor sangrado, menor necesidad de clampaje vascular y un tiempo de isquemia similar al grupo de nefrectomía parcial. Ambas técnicas son seguras a nivel oncológico, con una baja tasa de márgenes afectos. Ambas técnicas presentan una baja morbilidad postoperatoria.
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