Perioperative Care Following Open Radical Nephrectomy for Renal Cell Carcinoma

Abstract

Background: Renal cell carcinoma (RCC) is the most common renal tumor, accounting for 85% of all renal malignancies and 2% of all cancer deaths. Occurring most commonly in the sixth to seventh decades of life. Purpose: The study aimed to report on our experience in the management of patients with malignant renal masses regarding long-term complications and to assess the importance of long-term follow-up regarding renal function, local recurrence, and distant metastasis.

Methods: This was a hospital-based, case-retrospective, and prospective study. Total of 38 patients who had renal masses, 25 of them included in the study who had been diagnosed with RCC and underwent radical nephrectomy (RN) were investigated. Tumor-related characteristics, operative techniques, postoperative complications, full histopathological data, and follow-up results were documented.

Results: 25 patients with RCC with age distribution of 17 - 87 years median (50 y),16 male and 9 female patients with a median follow-up of 20 months (12 – 36 months), mild renal impairment in 4 patients (16%) with no need for dialysis, with proteinuria in 16% associated with history of diabetes mellitus (DM), with a mortality rate of 8%.

Conclusions: Osteoradionecrosis (ORN) is a safe procedure with low morbidity and mortality rates. Younger age at diagnosis in our study. Comorbidities and renal impairment are less than the international records, which may be attributed to the younger mean age of the patients. Subclinical metastasis remains a risk factor for death, even with strict preoperative investigations.