Eur J Pediatr Surg 2007; 17(6): 382-386
DOI: 10.1055/s-2007-989219
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Compensatory Renal Growth in Children with Unilateral Renal Tumor Treated by Nephron-Sparing Surgery or Nephrectomy

F. Cozzi1 , A. Zani1 , A. Schiavetti2 , F. Morini1 , V. deGaetano1 , M. Matrunola3 , D. A. Cozzi1
  • 1Department of Pediatric Surgery Unit, University of Rome “La Sapienza”, Rome, Italy
  • 2Department of Pediatric Oncology Unit, University of Rome “La Sapienza”, Rome, Italy
  • 3Department of Pediatric Radiology Unit, University of Rome “La Sapienza”, Rome, Italy
Further Information

Publication History

received April 27, 2007

accepted May 23, 2007

Publication Date:
11 December 2007 (online)

Abstract

Introduction: In children with an unilateral renal tumor, nephron-sparing surgery (NSS) results in a more adequate renal function adaptation compared to nephrectomy. In the present study, we investigated whether nephron-sparing surgery is followed by a different renal structure adaptation compared to nephrectomy. Methods: Sixteen patients with unilateral renal tumor treated by nephrectomy (Group 1) and 10 treated by nephron-sparing surgery (Group 2) were enrolled in the study. Kidney volume was estimated by ultrasonography, using the formula for a prolate ellipsoid. Kidney volume was adjusted to the patient's weight and kidney laterality and expressed as a percentage of the expected volume of two kidneys in a healthy child. Total kidney volume (TKV) corresponded to the volume of the contralateral kidney in Group 1 patients, and to the volume of contralateral kidney + kidney remnant in Group 2 patients. Renal function was evaluated by serum creatinine values adjusted for sex and age and expressed as standard deviation scores (SDS). Results: Group 2 patients presented with a greater indexed TKV compared to Group 1 patients, (97.4 ± 18.8 % vs. 77.0 ± 17.7 %; p = 0.005). Indexed TKV below the reference range for healthy controls with two kidneys was found in 4 of 10 Group 2 patients vs. 14 of 16 Group 1 patients (p = 0.017). In both patient groups, correlation analysis of indexed TKV and creatinine SDS showed a negative correlation (r = - 0.47; p = 0.01). Conclusion: In children with unilateral renal tumor, NSS is followed by a more adequate compensatory restoration of TKV compared with nephrectomy.

References

Prof. M.D. Francesco Cozzi

Department of Pediatric Surgery Unit
University of Rome “La Sapienza”

Viale Regina Elena 324

00161 Rome

Italy

Email: [email protected]