Factors Associated with Peritumoral Adhesions during Nephrectomy after Renal Mass Biopsy

Kyo Chul Koo, Won Sik Jang, Dong Hyuk Kang and Won Sik Ham

Department of Urology, Yonsei University College of Medicine, Korea

^*Correspondance to: Won Sik Ham 

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Abstract:

Objectives: To analyze factors associated with peritumoral adhesions (PTAs) during nephrectomy performed after Renal Mass Biopsy (RMB).Methods: From January 2009 to September 2013, 80 patients underwent Radical Nephrectomy (RN) or Partial Nephrectomy (PN) following RMB for renal masses that were ambiguous for malignancy on preoperative computed tomography imaging. Patients whose final pathology revealed urothelial carcinoma were excluded. PTAs were prospectively categorized as grade I (from no to moderate) and II (severe) by the operating surgeon immediately after surgery. Multivariate logistic regression analysis was performed to analyze factors associated with PTA.Results: Among the 80 patients, 60 (75%) were diagnosed as renal cell carcinoma (RCC) and 20 (25%) as benign tumors. The benign tumors included 10 (12.5%) angiomyolipomas, 5 (6.3%) oncocytomas, and 5 (6.3%) leiomyomas. Patients with grade II PTAs had a higher estimated blood loss. There was no conversion to RN in 30 patients treated by PN for RCC; however, of the 20 patients with benign tumors, 10 (50.0%) underwent unplanned conversion to RN. Among the 10 patients who underwent PN for benign tumors, 5 (50.0%) experienced postoperative pseudoaneurysms. Multivariate analysis revealed a younger age (p=0.039), higher Body Mass Index (BMI) (p=0.013), benign pathology (p=0.001), and more numbers of biopsy cores (p=0.045) as independent predictors for grade II PTAs.Conclusions: Compared to patients with RCC, younger patients with benign renal tumors were more likely to have severe PTAs during nephrectomy following RMB, especially those with a high BMI. Therefore, surgical treatment should be carefully planned for these patients.

Keywords:

Biopsy; Needle; Nephrectomy; Tissue adhesions

Cite the Article:

Koo KC, Jang WS, Kang DH, Ham WS. Factors Associated with Peritumoral Adhesions during Nephrectomy after Renal Mass Biopsy. Clin Oncol. 2016; 1: 1117.