Características clínicas, resultados funcionales y oncológicos de los pacientes con tumores renales tratados con nefrectomía parcial
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v79i1.393Palabras clave:
Neferectomía parcialResumen
Antecedentes: La nefrectomía parcial (NP) se ha convertido en el manejo estándar de los tumores T1 (£ 7cm) y/o en riñón único, tumores bilaterales y cáncer hereditario. En México existen pocos estudios que reporten los resultados de dicho procedimiento.
Objetivo: Conocer las características clínicas, morbilidad perioperatoria y resultados oncológicos y funcionales de la NP en el INCan.
Materiales y métodos: Estudio retrospectivo y analítico de los pacientes de NP del año 2000 al 2018. Se reportaron resultados oncológicos y perioperatorios.
Resultados: Se analizaron 79 pacientes con 82 NP. Edad media 52 años. El T clínico fue T1a y T1b en 62 (74.6%) y 20 (24.4%) casos respectivamente. Se realizó isquemia caliente en 39 (47.6%) y sin isquemia en 35 (42.7%). La media de tiempo quirúrgico, sangrado y estancia hospitalaria fue de 162 min, 449 ml y 2.1 días respectivamente. El abordaje abierto fue en 70 (85.4%) y laparoscópico en 12 (14.6%). Las complicaciones tempranas se presentaron en 17 (20%) incluyendo 9 (11%) transfusiones; 66 (80.5%) procedimientos reportaron células claras. Los márgenes quirúrgicos fueron negativos en 73 (89%). La sobrevida cáncer específica y sobrevida global a los 5 años fue de 100% y 92% respectivamente. La media estimada de tasa de filtración glomerular (TFG) prequirúrgica fue 88ml/min y de 79ml/min al año. La isquemia renal influyó en la disminución de la TFG.
Conclusiones: La CCN en nuestros pacientes muestra resultados similares a lo reportado en otros centros de experiencia internacional por lo que intentar realizarlo en todos los tumores T1 es seguro en nuestra población.
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