PMID- 21794068
OWN - NLM
STAT- MEDLINE
DCOM- 20120301
LR  - 20120116
IS  - 1464-410X (Electronic)
IS  - 1464-4096 (Linking)
VI  - 109
IP  - 3
DP  - 2012 Feb
TI  - Morbidity of tumour enucleation for renal cell carcinoma (RCC): results of a 
      single-centre prospective study.
PG  - 372-7; discussion 378
LID - 10.1111/j.1464-410X.2011.10360.x [doi]
AB  - OBJECTIVE: To evaluate the incidence and risk factors of adverse events (AEs) 
      after tumour enucleation (TE). PATIENTS AND METHODS: Between 2006 and 2009, 
      clinical, surgical and functional data were prospectively gathered from 200 
      consecutive patients who had open TE. TE was done by blunt dissection using the 
      natural cleavage plane between the tumour capsule and normal parenchyma. All the 
      AEs were stratified for severity according to the National Cancer Institute 
      Common Toxicity Criteria version 2.0 grading system. Risk factors for AEs were 
      determined by univariate analysis. RESULTS: The mean (range) tumour size was 3.2 
      (0.8-10.0) cm, and mean (range) warm ischaemia time (WIT) was 16.5 (5-31) min. 
      Overall, 32 AEs (six grade I, 20 grade II, and six grade III) occurred after TE 
      in 30 patients and of those 27 were surgical (13.5%) and five were medical AEs 
      (2.5%). On univariate analysis, imperative/relative surgical indication was the 
      only predictive factor for the development of medical AEs. Statistically 
      significant predictors of overall surgical AEs and urinary fistula were clinical 
      tumour dimension, completely endorenal tumour growth and a positive tumour 
      relationship with the urinary collecting system (UCS). A completely endorenal 
      tumour growth and a positive tumour relationship with the UCS also correlated 
      with bleeding requiring transfusions. Completely endorenal tumour growth was 
      significantly associated with major (grade III) AEs. CONCLUSIONS: The TE 
      technique was associated with a 16% AE rate and of those only 3% required 
      re-intervention (grade III). Urinary fistula occurred in six patients (3%) and 
      ureteric stenting was required in 0.5% of cases.
CI  - (c) 2011 THE AUTHORS; BJU INTERNATIONAL (c) 2011 BJU INTERNATIONAL.
FAU - Minervini, Andrea
AU  - Minervini A
AD  - Department of Urology, University of Florence, Careggi Hospital, Italy. 
      andreamine@libero.it
FAU - Vittori, Gianni
AU  - Vittori G
FAU - Lapini, Alberto
AU  - Lapini A
FAU - Tuccio, Agostino
AU  - Tuccio A
FAU - Siena, Giampaolo
AU  - Siena G
FAU - Serni, Sergio
AU  - Serni S
FAU - Carini, Marco
AU  - Carini M
LA  - eng
PT  - Journal Article
DEP - 20110728
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Renal Cell/pathology/*surgery
MH  - Female
MH  - Humans
MH  - Kidney Neoplasms/pathology/*surgery
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Nephrectomy/methods
MH  - Postoperative Complications/*etiology
MH  - Prospective Studies
MH  - Risk Factors
MH  - Tumor Burden
MH  - Warm Ischemia
MH  - Young Adult
EDAT- 2011/07/29 06:00
MHDA- 2012/03/02 06:00
CRDT- 2011/07/29 06:00
PHST- 2011/07/29 06:00 [entrez]
PHST- 2011/07/29 06:00 [pubmed]
PHST- 2012/03/02 06:00 [medline]
AID - 10.1111/j.1464-410X.2011.10360.x [doi]
PST - ppublish
SO  - BJU Int. 2012 Feb;109(3):372-7; discussion 378. doi: 
      10.1111/j.1464-410X.2011.10360.x. Epub 2011 Jul 28.