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Surgical Enucleation for the Treatment of Renal Tumors

Introduction: We analyzed our institutional experience with surgical enucleation for the primary treatment of small renal tumors. Materials and Methods: Patient demographics, histological features, effect of different types of vascular control and outcome from surgery were analyzed in 45 patients. A majority of the tumors (67%) were diagnosed incidentally. Results: All were stage T1, 77% were low grade (I–II) and 23% were high grade (III–IV). Complication occurred in 12% of patients. At a mean follow-up of 34 months (range 7–97), 28 of 33 patients (84%) with malignant tumors were alive without evidence of disease. One patient with a solitary kidney developed recurrent tumor after enucleation that required nephrectomy. Mean operative time was significantly lower with the compression technique versus direct vascular control (164 ± 12 min vs. 233 ± 15 min, p = 0.002). There were no differences in outcome between the two techniques. Conclusions: Surgical enucleation is a safe and viable procedure for the treatment of small renal tumors. Manual compression of the kidney appears to be at least as effective as clamping of the renal vessels in obtaining vascular control during the procedure and is more expeditious.