The efficacy of open nephron-sparing surgery in the treatment of complex renal cell carcinoma.

OBJECTIVE: To analyze the efficacy of open nephron-sparing surgery (NSS) in the treatment of complex renal cell carcinoma.

PATIENTS AND METHODS: A total of 118 patients with complex renal cell carcinoma (T1N0M0, clear cell carcinoma) were included in this study, and assigned into open radical nephrectomy (RN) group (35 patients), open NSS group (45 patients) and laparoscopic NSS group (38 patients). After 3 years of follow-up, the clinical efficacy was analyzed.

RESULTS: Both the mean surgery time and ischemia blocking time in the open NSS group were comparable to those in the RN group, and significantly shorter than the laparoscopic NSS group, p < 0.05. The rate of positive margin in the open NSS group was significantly lower than the laparoscopic NSS group. The occurrence of total complications in the open NSS group was comparable to that in the laparoscopic NSS group and significantly lower than the RN group. The successful rate of surgery in the open NSS group was significantly higher than the laparoscopic NSS group, p < 0.05. The 75% survival was 30.0 months in the RN group, > 35.0 months in the open NSS group and 34.0 months in the laparoscopic NSS group, the difference was significant (p < 0.001). The mortality was similar in the open NSS group and the laparoscopic NSS group, and significantly smaller than the RN group, p < 0.05.

CONCLUSIONS: Open NSS was more safe and effective in the treatment of complex renal cell carcinoma than RN and laparoscopic NSS.