.: ORİJİNAL ARAŞTIRMA
Benign Lesions Detected in Patients Undergoing Nephrectomy for Renal Mass: Single Center Experiences
Renal Kitle Tanısı ile Operasyon Yapılan Hastalarda Saptanan Benign Lezyonlar: Tek Merkez Deneyimi
J Reconstr Urol. 2019;9(3):73-8
doi: 10.5336/urology.2019-72133
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Lesions with benign features might be detected in some of the patients who undergo surgery with re-diagnosis of renal tumor. In our study, we aimed to evaluate the patients who underwent nephrectomy with various methods and whose histopathological examination results were benign. Material and Methods: A total of 203 patients who underwent partial or radical nephrectomy due to diagnosis of renal masses between April 2015 and December 2018 and followed-up regularly in our clinic were evaluated retrospectively. The nephrectomy operations were performed using open, laparoscopic or robot-assisted laparoscopic methods. Demographic data, radiological findings, surgical methods, histopathological data, follow- up periods and recurrence status were recorded as patient characteristics. Results: The mean age and body mass index (BMI) of the patients were 56.7 ± 12.3/year and 27.9 ± 4.2/kg/m2, respectively. In the preoperative evaluation, American Society of Anesthesiologist (ASA) II (139 [68.4%] score and T1a (87 [48.3%]) staging were most commonly seen in the study. Benign pathology was detected histopathologically in 22 (10.8%) patients. These lesions were oncocytoma in 7 (3.4%) patients, angiomyolipoma in 9 (4.4%) patients, simple cyst in 3 (1.4%) patients, chronic interstitial nephritis in 2 (0.9%) patients and hydatid cyst in 1 (0.4%) patient, respectively. Recurrent lesions occured in 4 (1.9%) patients during the mean follow-up period of 19.3 months. Conclusion: Benign lesions in renal masses after nephrectomy are encountered despite recent advances in imaging techniques. Clinical evaluation of radiologically suspected lesions should be performed well and additional diagnostic methods should be applied.
Keywords: Carcinoma, renal cell; nephrectomy; kidney neoplasms
Objective: Lesions with benign features might be detected in some of the patients who undergo surgery with re-diagnosis of renal tumor. In our study, we aimed to evaluate the patients who underwent nephrectomy with various methods and whose histopathological examination results were benign. Material and Methods: A total of 203 patients who underwent partial or radical nephrectomy due to diagnosis of renal masses between April 2015 and December 2018 and followed-up regularly in our clinic were evaluated retrospectively. The nephrectomy operations were performed using open, laparoscopic or robot-assisted laparoscopic methods. Demographic data, radiological findings, surgical methods, histopathological data, follow- up periods and recurrence status were recorded as patient characteristics. Results: The mean age and body mass index (BMI) of the patients were 56.7 ± 12.3/year and 27.9 ± 4.2/kg/m2, respectively. In the preoperative evaluation, American Society of Anesthesiologist (ASA) II (139 [68.4%] score and T1a (87 [48.3%]) staging were most commonly seen in the study. Benign pathology was detected histopathologically in 22 (10.8%) patients. These lesions were oncocytoma in 7 (3.4%) patients, angiomyolipoma in 9 (4.4%) patients, simple cyst in 3 (1.4%) patients, chronic interstitial nephritis in 2 (0.9%) patients and hydatid cyst in 1 (0.4%) patient, respectively. Recurrent lesions occured in 4 (1.9%) patients during the mean follow-up period of 19.3 months. Conclusion: Benign lesions in renal masses after nephrectomy are encountered despite recent advances in imaging techniques. Clinical evaluation of radiologically suspected lesions should be performed well and additional diagnostic methods should be applied.
Keywords: Carcinoma, renal cell; nephrectomy; kidney neoplasms
ÖZET
Böbrek tümörü ön tanısı ile cerrahi uygulanan hastaların bir bölümünde benign özelliklere sahip olan lezyonlar tespit edilmektedir. Biz de çalışmamızda kliniğimizde çeşitli yöntemlerle nefrektomi yapılan ve histopatolojik incelemeleri benign olarak sonuçlanan hastaların değerlendirilmesini amaçladık. Gereç ve Yöntemler: Kliniğimizde Nisan 2015 ve Aralık 2018 yılları arasında renal kitle nedeniyle parsiyel veya radikal nefrektomi yapılan ve düzenli takip edilen 203 hasta retrospektif olarak değerlendirildi. Hastaların nefrektomi operasyonları açık, laparoskopik veya robotik olarak gerçekleştirildi. Hastaların tanı yaşı, demografik verileri, radyolojik bulguları, uygulanan cerrahi yöntemler, histopatolojik verileri, takip süreleri ve nüks durumları kayıt edildi. Bulgular: Hastaların ortalama yaş değerleri ve beden kitle indeksleri (BKİ) sırasıyla 56,7±12,3/yıl ve 27,9±4,2/kg/m2 olarak bulundu. Operasyon öncesi değerlendirmede hastaların çoğunluğunun Amerikan Anesteziyoloji Derneği (ASA) II (139 [%68,4] olduğu ve T1a (87 [%48,3]) evrelemeye sahip oldukları belirlendi. Operasyon sonrası yapılan histopatolojik değerlendirmede 22 (%10,8) hasta benign patolojiye sahipti. Bu lezyonlar sırasıyla 7 (%3,4) hastada onkositom, 9 (%4,4) hastada anjiomyolipom, 3 (%1,4) hastada basit kist, 2 (%0,9) hastada kronik interstisyel nefrit ve 1 (%0,4) hastada kist hidatik olarak belirlendi. Ortalama 19,3 aylık takip sürecinde operasyon sonrası sadece 4 (%1,9) hastada nüks lezyon gözlendi. Sonuç: Son yıllarda görüntüleme yöntemlerindeki gelişmelere rağmen renal kitlelerde nefrektomi sonrası benign lezyonlarla karşılaşabilmekteyiz. Bu nedenle radyolojik olarak şüpheli lezyonlarda klinik değerlendirme iyi yapılmalı ve ek tanı yöntemlerine başvurulmalıdır.
Anahtar Kelimeler: Karsinom, renal hücreli; nefrektomi; böbrek neoplazileri
Böbrek tümörü ön tanısı ile cerrahi uygulanan hastaların bir bölümünde benign özelliklere sahip olan lezyonlar tespit edilmektedir. Biz de çalışmamızda kliniğimizde çeşitli yöntemlerle nefrektomi yapılan ve histopatolojik incelemeleri benign olarak sonuçlanan hastaların değerlendirilmesini amaçladık. Gereç ve Yöntemler: Kliniğimizde Nisan 2015 ve Aralık 2018 yılları arasında renal kitle nedeniyle parsiyel veya radikal nefrektomi yapılan ve düzenli takip edilen 203 hasta retrospektif olarak değerlendirildi. Hastaların nefrektomi operasyonları açık, laparoskopik veya robotik olarak gerçekleştirildi. Hastaların tanı yaşı, demografik verileri, radyolojik bulguları, uygulanan cerrahi yöntemler, histopatolojik verileri, takip süreleri ve nüks durumları kayıt edildi. Bulgular: Hastaların ortalama yaş değerleri ve beden kitle indeksleri (BKİ) sırasıyla 56,7±12,3/yıl ve 27,9±4,2/kg/m2 olarak bulundu. Operasyon öncesi değerlendirmede hastaların çoğunluğunun Amerikan Anesteziyoloji Derneği (ASA) II (139 [%68,4] olduğu ve T1a (87 [%48,3]) evrelemeye sahip oldukları belirlendi. Operasyon sonrası yapılan histopatolojik değerlendirmede 22 (%10,8) hasta benign patolojiye sahipti. Bu lezyonlar sırasıyla 7 (%3,4) hastada onkositom, 9 (%4,4) hastada anjiomyolipom, 3 (%1,4) hastada basit kist, 2 (%0,9) hastada kronik interstisyel nefrit ve 1 (%0,4) hastada kist hidatik olarak belirlendi. Ortalama 19,3 aylık takip sürecinde operasyon sonrası sadece 4 (%1,9) hastada nüks lezyon gözlendi. Sonuç: Son yıllarda görüntüleme yöntemlerindeki gelişmelere rağmen renal kitlelerde nefrektomi sonrası benign lezyonlarla karşılaşabilmekteyiz. Bu nedenle radyolojik olarak şüpheli lezyonlarda klinik değerlendirme iyi yapılmalı ve ek tanı yöntemlerine başvurulmalıdır.
Anahtar Kelimeler: Karsinom, renal hücreli; nefrektomi; böbrek neoplazileri
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