Radiographic vs surgical size of renal tumours after partial nephrectomy.

Abstract

To compare the radiographic with the surgical size of renal tumours selected for partial nephrectomy. In 50 patients undergoing elective partial nephrectomy for renal carcinoma (31 men and 19 women, preoperative tumour size 1.5-5. 2 cm) the maximum size of the renal tumour, as assessed from computed tomography (CT) before surgery, was compared with the tumour size at surgery. All patients had their renal artery temporarily occluded before surgery to shrink the kidney. After partial nephrectomy, the renal tumours were a mean of 0.63 cm smaller than the estimate from CT; tumours of >/= 3.5 cm on CT were particularly reduced. Incidentally discovered tumours on CT that are < 3.5 cm and favourably located are often selected for partial nephrectomy. If temporary vascular occlusion and surface hypothermia of the kidney causes shrinkage of most tumours of >/= 3. 5 cm, then surgeons might attempt partial nephrectomy in borderline cases, with a better chance of complete resection.