Razi Journal of Medical Sciences

Background: The aim of this study was to evaluate the outcome and survival in patients with RCC treated with non-hilar clamping simple enucleation.
Methods: In this case series study, all patients in Hashemi Nejad Hospital in Tehran undergone non-hilar clamping simple enucleation surgery in the years 1383 to 1393 by RCC T1 enrolled the study. Exclusion criteria included the presence of multi-focal RCC, synchronous mass in patients, the existence of positive lymph nodes before or during surgery and radical nephrectomy due to past RCC. 134 patients undergoing partial nephrectomy in tumors T1 (T1a, T1b) studied, 9 patients has not completed the follow up and 10 patients had oncocytoma and angiomyolipoma excluded the study. 115 patients with RCC pathology who undergone non-hilar clamping Simple Enucleation were examined.
Results: In this case series study, 115 patients with pathologically confirmed RCC were evaluated on the basis that 70patients were male and 45 were female. Patients have ranged in age from 20 to 75 years old and 51.28 year. Average figure of 97% progression free survival at three-year and five-year study was 89%. Also three-year study of cancer specific survival at five years was 100% and 95% respectively. Patients who have relapsed 2 female and 2 were male. The recurrence was not significantly associated with gender (p= 0.511). Also 2 patients had recurrence of the left kidney and 2 were all right and there was no statistically significant difference (p= 0.643). Every 4 patients recurrent disease have T1b the difference was significant (p= 0.026). Also patients had recurrence of grade 2 to grade 1 patients have high grade recurrence was observed (p<0.001). No significant difference was found between GFR before and 3 months after surgery (p= 0.802) and a biopsy of the tumor bed margins were negative in all cases.
Conclusion: Non-clamping SE in patients with T1 renal masses is similar to partial nephrectomy is onchologic results. In this study, recurrence was higher in patients with T1b tumors that appear in determining treatment and close follow-up T1 b should be more comprehensive criteria. Non clamping SE preserving kidney function is a good choice in the treatment of T1 tumors. Non clamping SE more complications following surgery and that could be more widely used.