Abstract：Objective:To report the experience of partial nephrectomy for renal cell carcinoma in patients with a solitary kidney at our institution, with analysis of renal function, complications, oncological efficacy and survival. Methods:We identified 15 consecutive patients with a solitary kidney who underwent partial nephrectomy between Jan. 1999 and May 2013. Variables examined included patient age and gender, renal function, renal ischemia time, surgical margin status and complications. Tumor size, histological subtype and tumor stage were also assessed. Results:The median age was 50 years (range: 39 to 71). The male/female ratio was 4:1. The mean operative time was 150 min. The renal artery was occluded in 10 of 15 patients and the mean warm ischemia time was 24 min. Gentle manual compression to the kidney was applied in the other 5 patients. The median blood loss was 300 mL. The median size of the tumor was 2.5 cm (range: 1.5 to 7.0). The histological subtype was clear cell carcinoma in 14 cases and papillary cell carcinoma in one case. All surgical margins were negative. The median creatinine level increased after the operation but that in 11 of them had returned to the baseline one month after the operation during the follow-up period. No patient required hemodialysis. Perioperative complications included acute renal failure and hematuria. The median follow-up was 51 months (range: 10 to 167). Bone metastasis was found in one patient, who was dead 32 months after the surgery. Local recurrence was found in 2 patients, who were treated by target therapy. Conclusions:Partial nephrectomy for renal cell carcinoma in patients with a solitary kidney can safely preserve renal function and effectively treat malignancy.
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