Recurrent renal cell carcinoma of solitary kidney: renal sparing surgery
57 years old female was admitted to the hospital absolutely asymptomatic. Previously on ultrasound investigation 3 renal neoplasms were detected. Five years ago patient underwent nephrectomy on the left for renal cell carcinoma. Preoperatively laboratory tests were in reference range. Patient underwent renal sparing surgery - all neoplasms were fully excised. After each excision arterial circulation was temporarily restored for up to 10 min. We call this - “start-break” technique. Also after excision it was better to assess hemostasis. Total warm ischemic time was 18 min. Total blood loss was 200ml. Patient’s condition was relatively stable and did not necessitate hemodialysis. She was discharged on 11th postop day. Renal cell carcinoma of the solitary kidney presents a great challenge either for the surgeons or patients, because it depends on what is the main purpose of treatment, because organ sparing surgery and radical surgery have mostly different outcomes in long-term period. The decision is made according to the clinical data, patient’s preference, safety and good quality of life for patient. But organ sparing surgery bears the risk of recurrence more than the radical surgery. So these aspects must be considered before the informed consent is taken.