SIMPLE ENUCLEATION VERSUS STANDARD PARTIAL NEPHRECTOMY FOR CLINICAL T1 RENAL MASSES: PERIOPERATIVE OUTCOMES BASED ON A MATCHED-PAIR COMPARISON OF 396 PATIENTS (RECORD PROJECT)

Scopo del lavoro To compare simple enucleation (SE) and standard partial nephrectomy (SPN) in terms of surgical results in a multicenter dataset (RECORd Project). Materiali e metodi patients treated with nephron sparing surgery (NSS) for clinical T1 renal tumors between January 2009 and January 2011 were evaluated. Overall, 198 patients who underwent SE were retrospectively matched with 198 patients who underwent SPN. The SPN and SE groups were compared regarding intraoperative, early pot-operative and pathologic outcome variables. Multivariate analysis was applied to analyse predictors of positive surgical margin (PSM) status. Risultati SE was associated with similar WIT (18 vs 17.8 min), lower intraoperative blood loss (177 vs 221 cc, p=0.02) and shorter operative time (121 vs 147 min; p20 minutes. The incidence of PSM was significantly lower in patients treated with SE (1.4% vs 6.9%; p=0.02). At multivariate analysis, PSM was related to the surgical technique, with a 4.7-fold increased risk of PSM for SPN compared to SE. The incidence of overall, medical and surgical complications was similar in both groups. Discussione The RECORd Project is a 4-Year prospective observational multicenter study promoted by the Italian Society of Urology. To our knowledge this is the first multicenter study based on a matched-pair comparison of patients treated by standard partial nephrectomy and simple enucleation. Conclusioni Type of NSS technique (SE vs SPN) adopted has a negligible impact on WIT and postoperative morbidity but SE seems protective against PSM occurrence.