Post Operative Complications Of Open Partial Nephrectomy With Respect To Tumour Location.

BACKGROUND: Partial Nephrectomy has been the go-to approach for the treatment of small sized renal tumours for years now. Like any other surgical procedure, it is associated with post-operative complications. The study was aimed at determining the post-operative complications of open partial nephrectomy concerning tumour location. METHODS: This descriptive cross-sectional study was done on 45 patients as per inclusion criteria. The patients were managed as per department protocols and were observed for the development of immediate post-operative complications during hospital stays. RESULTS: Post-operative complications were observed in 4 (8.9%) patients and included haemorrhage (n=1; 2.2%) and urine leak (n=3; 6.7%). There was a statistically significant association between post-operative complications of partial nephrectomy and central tumour location (p=0.008, OR=14.52 and LR=5.70) and increased age (p=0.04, LR=5.40 and OR=8.90). Discussion: Increased age and tumour location may play a significant role in determining the likelihood of post-operative complications in patients who have undergone surgery for renal tumours.

Anatomic Patterns Of Right Renal Vein.

BACKGROUND: Preoperative surgical planning assumes a central role in avoiding catastrophic outcomes of a surgery in the field of renal transplantation, and other urological procedures. This study was aimed to study the different anatomic patterns of human renal venous system. METHODS: It is a descriptive cross-sectional study including 50 adult male cadavers with well-preserved kidneys, renal vasculature and the inferior vena cava. Cadavers with deformed or congenitally anomalous kidney, evidence of surgery, solitary kidney, tumours of kidneys or injured renal vessels / inferior vena cava were excluded from the study. The kidneys, renal veins and the inferior vena cava were exposed. After securing inferior vena cava fifty ml mixture of Indian ink and gelatine was injected into renal veins via inferior vena cava and was allowed to solidify. Following this, the renal venous anatomy was studied. RESULTS: Twenty-eight cadavers had their right renal vein formed by 2 tributaries (56%), 13 (26%) had 3 tributaries, 5 (10%) had 4 tributaries, 1 cadaver had a posterior tributary (2%), while 3 cadavers had other numbers of tributaries (6%). Out of total 50 cadavers 40 (80%) had normal distribution of right renal vein. Additional renal veins were found in 14 (7%) cadavers, double renal veins in 1 (2%) and proximally double renal veins in 2 cadavers (4%).. CONCLUSIONS: There is considerable variation in renal venous anatomy. Knowledge of common venous patterns is necessary for minimizing intraoperative damage to renal anatomy and to prevent intra- and post-operative complications..

CLINICAL PRESENTATION OF RENAL CELL CARCINOMA.

BACKGROUND: Most common malignant tumour of the kidney is Renal Cell Carcinoma (RCC) and is known for its unpredictable clinical behaviour. Aetiology and risk factors are not completely understood. Extensive workup is being done in the understanding of the disease, especially to diagnose early and to treat promptly. The objective of this study was to determine the clinical presentation and pathological pattern of RCC. METHODS: After approval from ethical committee a retrospective review of records was conducted extending from January 2012 to January 2014 to identify clinical characteristics of renal cell carcinomas. The study included all renal cancer patients presented to Sheikh Zayed Hospital Lahore with in this specified period. The data was retrieved regarding, history, physical examination and necessary investigations such as ultrasonsgraphy of abdomen and pelvis and CT scan of abdomen and pelvis. RESULTS: There were total of 50 cases. The male to female ratio was 3:2. Mean age of patients were 52.38 (18-93) years old. Most common clinical presentation was gross haematuria (66%).The mean tumour size was 8.34 (3-24) cm. Tumour histology were clear cell (84%), papillary transitional cell carcinoma (12%) and oncosytoma contributed 4%. CONCLUSION: We observed that large number of the patients with RCC presented with haematuria and most of them were male. Common pathological type was clear cell carcinoma.