%0 Journal Article
%T Partial Nephrectomy for Renal Cell Carcinoma: Risk Factors for Acute Post-Operative Hemorrhage and Impact on Subsequent Hospital Course and Complete Nephrectomy Rate. An Analysis of 200 Consecutive Cases
%A James Cavalcante
%A Alan Perrotti
%A Philip Rabadi
%A Alicia McCarthy
%A Michael Perrotti
%J International Journal of Clinical Medicine
%P 5-9
%@ 2158-2882
%D 2013
%I Scientific Research Publishing
%R 10.4236/ijcm.2013.412A1002
%X <p class=\"MsoNormal\">
	<span lang=\"EN-US\" style=\"font-family:Verdana;\">Purpose:</span><span lang=\"EN-US\" style=\"font-family:Verdana;\"> Clinical guidelines recommend partial nephrectomy (PN) as the preferred method
of surgical excision</span><span lang=\"EN-US\"> </span><span lang=\"EN-US\" style=\"font-family:Verdana;\">of
the small renal tumor whenever feasible. PN has comparable cancer cure rates to
that of radical nephrectomy in this setting, and decreased risk of chronic
kidney disease. A recognized devastating complication following partial nephrectomy
is acute post</span><span lang=\"EN-US\" style=\"font-family:Verdana;\">-</span><span lang=\"EN-US\" style=\"font-family:Verdana;\">operative
hemorrhage</span><span lang=\"EN-US\"> </span><span lang=\"EN-US\"><span style=\"font-family:Verdana;\">(APOH) from the
reconstructed kidney. Risk factors for hemorrhage following partial nephrectomy
remain poorly elucidated, as does the impact of hemorrhage on subsequent
hospital stay. Identification of risk factors for hemorrhage may lead to a
better understanding of and reduction of this complication. </span><span style=\"font-family:Verdana;\">Material and Methods:</span><span style=\"font-family:Verdana;\"> We utilized a
prospectively managed database comprised of patients undergoing open partial
nephrectomy at our institution by the same surgical team </span></span><span lang=\"EN-US\" style=\"font-family:Verdana;\">from</span><span lang=\"EN-US\" style=\"font-family:Verdana;\"> January 2006 to July 2012. Clinicopathologic
factors assessed APOH for their relationships, including patient age, gender,
diabetes, smoking, hypertension, coronary artery disease, American Society of
Anesthesia Score (ASA), tumor size, RENAL nephrotomy score, pathologic result,
cancer margin status, operative time, and intra-operative blood loss. The
impact of APOH on subsequent hospital course was evaluated and compared </span><span lang=\"EN-US\" style=\"font-family:Verdana;\">with</span><span lang=\"EN-US\"><span style=\"font-family:Verdana;\"> the entire cohort. </span><span style=\"font-family:Verdana;\">Results:</span><span style=\"font-family:Verdana;\"> Data were analyzed from 200
consecutive patients. We identified 7 patients (3.5%) who experienced APOH. Compared </span></span><span lang=\"EN-US\" style=\"font-family:Verdana;\">with</span><span lang=\"EN-US\" style=\"font-family:Verdana;\"> the entire
cohort, APOH resulted </span><span lang=\"EN-US\" style=\"font-family:Verdana;\">in </span><span lang=\"EN-US\" style=\"font-family:Verdana;\">an
increased
%K Kidney Neoplasms
%K Partial Nephrectomy
%K Renal Cell Carcinoma
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=41124