Abstract: Background: Partial Nephrectomy (PN) or Nephron Sparing Surgery (NSS) is a major improvement in renal cell carcinoma (RCC) therapy, especially for bilateral or single kidney cancer patients. Originally, radical nephrectomy - complete kidney removal - was the usual treatment for RCC. However, with improved surgical skills and kidney cancer biology, PN has become a feasible, less invasive option, especially for certain patient populations. Aims of the study is to compare perioperative and short term data of hilar clamping and non-clamping partial nephrectomy for renal masses.
Method: A prospective study was conducted on 26 patients undergoing partial nephrectomy for renal masses at Rizgari Teaching Hospital and Zheen International Hospital from December 2018 to September 2019. The patients were divided into two groups: non-clamping (n = 16) and clamping (n = 10). The study involved documenting patient demographics, perioperative parameters, postoperative outcomes, and classifying patients based on nephrometry scores.
Results: In a study of partial nephrectomy patients, 65% were male with no significant gender difference between non-clamping and clamping groups. Non-clamp patients had higher estimated blood loss (484 vs 260 mL) and transfusion rates (43%), but no significant difference in postoperative hemoglobin. There was no significant difference in tumor size or short-term serum creatinine changes between the two groups, with more complex renal masses often undergoing clamping nephrectomy.
Conclusion: Non-clamp partial nephrectomy is used in most patients regardless of tumour size, however it causes greater blood loss and transfusions. Hilar clamping with correct ischemia time can be done (if needed) with minimum creatinine impact in a short postoperative period.
