SEARCH · PubMed Health

Results for “Nephrectomy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,387 records · Page 77Linked to original sources

PubMed1984

Long-term results following partial nephrectomy for localized renal adenocarcinoma.

From 1956 to 1980 partial nephrectomy was done on 23 patients with localized renal carcinoma occurring bilaterally or in a solitary functioning kidney. The mean postoperative followup was 5.4 years, and the 5-year patient survival rates considering death of renal cancer only or of any cause were 70.2 and 59.6 per cent, respectively. Survival was diminished in patients with bilateral asynchronous renal carcinoma. Renal carcinoma recurred postoperatively in 6 patients (26 per cent), including 3 (13 per cent) with local recurrence in the renal remnant. Currently, 12 patients (52 per cent) are alive with stable function and no evidence of malignancy. These long-term data support the efficacy of partial nephrectomy for selected patients with renal carcinoma.

Adenocarcinoma↗

PubMed1982

Living donor nephrectomy: factors influencing morbidity.

Recent interest in transperitoneal live donor nephrectomy prompted us to review our experience with 104 live donor nephrectomies performed through a standard flank extraperitoneal approach. There were no deaths and 14.4 per cent of the patients had minor complications that were managed easily. Factors influencing morbidity in the voluntary donor are analyzed.

Adult↗

PubMed1981

Anterior extraperitoneal donor nephrectomy.

The anterior extraperitoneal approach was compared to the flank approach for living donor nephrectomy in a series of 36 familial donors. The former procedure (23 cases) not only afforded superior visualization of renal vessels but also was probably at least as safe as the latter (13 cases) for donors with risk factors of obesity, age more than 45 years and pulmonary disease. Anterior extraperitoneal nephrectomy appears to be indicated for donors with multiple renal arteries and skeletal deformities, including thoracolumbar arthritis.

Adolescent↗

PubMed1980

Experience with live donor nephrectomy.

We studied 100 patients undergoing nephrectomy for living related renal transplantation. after completion of tissue typing preoperative studies included urinalysis and culture, creatinine clearance determination, excretory urography and renal arteriography. Patient characteristics, preoperative test, surgical approach, complications, long-term followup and cost factors were reviewed. There was no mortality and morbidity was minimal except for wound complications. Renal function generally remained normal. Donor nephrectomy is a worthwhile and safe procedure with an acceptably low incidence of postoperative complications.

Adolescent↗

PubMed1980

Ventriculoureteral shunt for hydrocephalus without nephrectomy.

The urinary tract has been used previously for shunting of cerebrospinal fluid. However, nephrectomy has always accompanied the procedure, making it less appealing despite adequate relief of hydrocephalus. By using reimplantation of the ureter and a psoas hitch we have performed the first reported ventriculoureterostomy without nephrectomy. To date the results in 3 patients have been excellent from a neurosurgical and urologic standpoint.

Cerebrospinal Fluid Shunts↗

PubMed1977

Nephrectomy: indications and complications in 347 patients.

The indications, complications and mortality rate in a recent 12-year experience with 347 nephrectomies were reviewed. Renal tumor is the most frequent condition requiring nephrectomy, probably because of the improved, non-ablative methods to treat inflammatory, obstructive, calculous and hypertensive renal disease. The over-all mortality rate was 1.4 per cent but was almost nil in the absence of malignancy.

Adolescent↗

PubMed1977

T and B lymphocyte levels in renal cancer patients: influence of preoperative transcatheter embolization and radical nephrectomy.

The mean percentage of T and B lymphocytes in peripheral blood was tested in 6 patients with renal cancer before and after preoperative transcatheter embolization and radical nephrectomy. While no significant difference was found in B lymphocyte levels compared to those in healthy control subjects a clear impairment in circulating T lymphocyte levels was observed in renal cancer patients who had not been treated. This reduction in T lymphocyte levels persisted after embolization but there was a significant increase after radical nephrectomy.

Adult↗

PubMed1976

The present status of bilateral nephrectomy in transplant recipients.

Routine use of bilateral nephrectomy in renal transplant patients has been replaced by a careful evaluation of the indications for the procedure and the increasing appreciation of the contributions of non-excretory kidneys. These contributions are identified and the indications are discussed. When bilateral nephrectomy is required the clear superiority of the bilateral simultaneous posterior approach over other techniques is documented.

Functional Laterality↗

PubMed1975

Emphysematous pyelonephritis: report of 3 cases treated by nephrectomy.

Three cases of emphysematous pyelonephritis are presented. All 3 patients were diabetics, they all had Escherichia coli and there was evidence of ureteral obstruction in 1 case only. All 3 patients underwent nephrectomy and survived. Initial evaluation should be performed to rule out ureteral obstruction. Treatment should consist of a brief trial of high dose antibiotic therapy with serious consideration of nephrectomy in the face of persistent symptoms or gas. Incision and drainage are reserved for poor surgical risk patients. All patients should remain on antibacterial therapy and have frequent followup examinations.

Abscess↗

PubMed1985

The risks of unilateral nephrectomy: status of kidney donors 10 to 20 years postoperatively.

We received requested follow-up information from 105 (73%) of our 144 kidney donors who had undergone unilateral nephrectomy 10 to 20 years previously. Five donors had died of unrelated causes 6 or more years postoperatively. Studies in the remaining 100 donors showed that the current mean serum creatinine concentration was 1.2 mg/dl and the mean 24-hour urinary protein value was 89 mg. Hypertension (defined as 160 mm Hg or more systolic, 95 mm Hg or more diastolic, or both) was present in 19% of the donors. In a subgroup of 66 donors who had had serial serum creatinine determinations, the renal function, as estimated on the basis of these serum creatinine values, had not deteriorated with time. Thus, we consider unilateral nephrectomy in this group of patients relatively safe. Subsequent evaluation will be necessary to ascertain whether these findings prevail.

Adolescent↗

PubMed2000

Retroperitoneal laparoscopic nephrectomy is safe and effective in obese patients: a comparative study of 55 procedures.

OBJECTIVES: To compare the results of retroperitoneal laparoscopic nephrectomy (RLN) in obese and nonobese patients, because various open surgical procedures have been reported to result in higher morbidity in obese patients. METHODS: Forty-eight consecutive patients underwent 55 RLNs in one center by one surgeon. Twenty-two patients were renal transplant recipients and underwent a total of 29 RLNs of the native kidney. Eight patients (9 procedures) were obese (body mass index 30 or more). The duration of the procedure, intraoperative and postoperative complications, and length of stay were compared between the obese and nonobese patients. RESULTS: The median operative duration was 100 and 70 minutes in the obese and nonobese patients, respectively. Three intraoperative complications occurred in nonobese patients. One postoperative complication (12. 5%) occurred in the obese patients; four (15.6%) occurred the nonobese patients. The median length of stay was 4 days for the obese and 3 days for the nonobese patients. The complication rate and postoperative length of stay were not significantly different between the two groups. CONCLUSIONS: RLN in obese patients was not associated with higher morbidity or longer hospitalization than in nonobese patients. We believe that RLN should be proposed to such patients when nephrectomy of a small nonfunctional kidney is indicated.

Adult↗

PubMed2001

Dual stent placement for the treatment of a persistent urine leak after partial nephrectomy.

Persistent urine leak is a known complication after partial nephrectomy. In the present case, a partial nephrectomy was performed to remove a large, centrally located, renal mass in an elderly man with a solitary functioning kidney. A persistent urine leak refractory to single stent drainage was successfully treated after two stents were placed in the ipsilateral renal unit such that the upper and lower calices were drained by separate stents.

Aged↗

PubMed2001

Hemostatic laparoscopic partial nephrectomy: initial experience with the radiofrequency coagulation-assisted technique.

OBJECTIVES: The techniques for hemostasis after renal tumor excision have limited the widespread application of laparoscopic partial nephrectomy (LPN). To improve hemostasis and aid visualization, we report our experience with a novel radiofrequency coagulation (RFC) technique for LPN. METHODS: Ten patients underwent RFC-assisted LPN. The demographic and perioperative data were tabulated. Patients were positioned as for laparoscopic nephrectomy, and laparoscopic ports were placed. The kidney within Gerota's fascia was mobilized, and the fat overlying the tumor was carefully removed for pathologic evaluation. Under laparoscopic guidance, a radiofrequency probe was percutaneously inserted into the lesion and deployed to coagulate the lesion and a margin of normal parenchyma. Laparoscopic scissors were used to excise the lesion; additional hemostatic maneuvers were used selectively. RESULTS: The mean renal tumor size was 2.1 cm (range 1.0 to 3.2). The median operative time was 170 minutes and the median blood loss was 125 mL. The RFC technique resulted in complete tissue coagulation within the treated volume, thereby facilitating intraoperative visualization, minimizing blood loss, and permitting rapid and controlled tumor resection. The renal architecture was preserved, allowing accurate diagnosis of renal cell carcinoma and angiomyolipoma in 9 and 1 cases, respectively. No perioperative complications occurred. CONCLUSIONS: The use of RFC is an effective method to facilitate LPN of both exophytic and endophytic masses. By coagulating a margin of normal parenchyma, the technique minimizes blood loss and improves visualization during LPN. We anticipate this technique will broaden the clinical application for LPN.

Adult↗

PubMed2001

Delayed nephrectomy in grade V renal injury with two interesting anatomic variations.

The decision to perform early nephrectomy in hemodynamically stable grade V injury rather than to provide supportive nonoperative care is not universally accepted. The management of isolated grade V renal injury, as well as the management of coexisting abdominal trauma that requires operative intervention, is an area of controversy. We present the case of a grade V renal injury that was initially managed expectantly at a level I trauma center. After transfer to our facility, nephrectomy was performed. The case illustrates the merit of prompt definitive surgical treatment.

Adult↗

PubMed2002

Comparison of costs and complications of radical and partial nephrectomy for treatment of localized renal cell carcinoma.

OBJECTIVES: To compare the complications and costs of radical and partial nephrectomy (PN) and to investigate the impact of increasing experience on costs and complications during a 7-year period. Nephron-sparing surgery has found increasing applications in the past decade. PN has achieved similar long-term results in localized renal cell carcinoma with respect to cancer control compared with radical nephrectomy (RN). However, data are limited on the direct comparison of complications and hospital costs between these two modalities. METHODS: A retrospective case-matched study was performed comparing 60 RNs and 60 PNs during a 7-year period with respect to complications and hospital costs. A longitudinal comparison was also performed between the various periods to assess the impact of surgical experience on these parameters. RESULTS: The mean length of stay was 6.4 +/- 3 days in the RN group and 6.4 +/- 3.3 days in the PN group. The hospital costs were comparable between the two procedures during the observed interval. The mean operative time was 176.6 +/- 51.6 minutes for RN and 220.1 +/- 59.6 minutes for PN (P = 0.0001). This difference was accentuated during the observed period. No differences were found in the blood loss and transfusion rates between the groups. The complication rate was 3.3% and 10% for RN and PN, respectively (P = 0.2). CONCLUSIONS: Our data suggest that RN and PN can be performed with a similar rate of complications and comparable hospital costs. This is of practical importance when comparing these modalities as treatment options for localized renal cell carcinoma.

Adult↗

PubMed2003

Laparoscopic radical nephrectomy incorporating intraoperative ultrasonography for renal cell carcinoma with renal vein tumor thrombus.

The purpose of this study was to describe the technique of laparoscopic right radical nephrectomy incorporating intraoperative, real-time ultrasonography in the management of renal cell carcinoma with level 1 renal vein tumor thrombus. With the patient in a modified flank position, a transperitoneal four-port approach was used to laparoscopically resect an 8.5-cm right renal mass with tumor thrombus extending to, but not into, the inferior vena cava. Early arterial control with gentle traction on the right renal vein provided a short proximal renal venous segment devoid of tumor on laparoscopic inspection. Intraoperative laparoscopic ultrasonography allowed confident identification of the proximal extent of the tumor thrombus. After hilar control, complete resection and intact removal of the renal specimen was performed using standard non-hand-assisted laparoscopic techniques. The actual surgical time was 180 minutes. Surgical resection was successfully performed laparoscopically. No postoperative complications or hospital readmission occurred. Pathologic examination confirmed T3b renal cell carcinoma with negative surgical margins. Laparoscopic right radical nephrectomy incorporating intraoperative, real-time ultrasonography is feasible in the management of renal cell carcinoma with a large-sized level 1 renal vein thrombus. Additional studies are necessary to evaluate its role in urologic oncologic surgery.

Aged↗

PubMed1997

Partial nephrectomy for pediatric renal cell carcinoma: an unusual case presentation.

Nine years after successful treatment of Stage IV neuroblastoma, a 10-year-old white girl was demonstrated to have a complex cystic mass in the upper pole of her solitary right kidney. Partial nephrectomy was performed, disclosing a renal cell carcinoma, predominantly clear cell type. No metastases were detected. Renal cell carcinoma is a rare cause of secondary malignancy. Partial nephrectomy can be used successfully to treat renal cell carcinoma in children.

Carcinoma, Renal Cell↗

PubMed1998

Partial nephrectomy: alternative treatment for selected patients with renal cell carcinoma.

OBJECTIVES: To analyze the experience and the results of partial nephrectomy in a single institution over the last 10 years in order to optimize patient selection and minimize morbidity. METHODS: This is a retrospective chart review of 64 patients (mean age 56.6 years, range 18 to 88; 43 men, 21 women) who underwent 66 partial nephrectomies at the Brigham and Women's Hospital between 1987 and 1997. Preoperatively, 62% of the patients had no symptoms, whereas 38% had pain and/or hematuria. The indications were elective in 23 patients, solitary kidney in 28 (14 with bilateral asynchronous tumor), bilateral synchronous tumor in 7, von Hippel-Lindau disease with normal contralateral kidney in 3, lymphoma in 3, and other indications in 2 patients. Surgery was performed for solid or indeterminate renal mass suspected of being renal cell carcinoma in 58 patients. RESULTS: The most common final pathologic diagnosis was renal cell carcinoma in 47 procedures. One or more complications occurred after 18 procedures (15 with solitary kidney and 3 in patients with normal contralateral kidney) or 27% of the patients. The most common complication was an increased creatinine level (two times the baseline), occurring in 10 procedures (15.1%). Transfusion was necessary in 37 of 66 procedures (56%), and the mean blood loss was 836 cc (range 100 to 3200). Regarding renal function, 85% of the patients had a minimal increase in creatinine of less than 0.5 mg/dL after surgery (all patients with a normal contralateral kidney are in this group); 3 patients required either temporary (n = 1) or permanent (n = 2) dialysis. Other complications are also described. The mean length of stay among 65 patients was 6.5 days (range 3 to 14). The differences between length of stay, blood loss, and tumor size were statistically significant between the solitary kidney group and the elective indications group (P < 0.001). CONCLUSIONS: Nephron sparing surgery is feasible and relatively safe in patients with a normal contralateral kidney. Awareness of potential complications should aid in the selection of appropriate patients for this procedure.

Adolescent↗