To determine the scope and outcomes of nephron-sparing surgery (NSS) across the UK and in so doing set a realistic benchmark and identify fresh contemporary challenges in NSS .
In 2012 reporting of outcomes of all types of nephrectomy became mandatory in the UK.
148 surgeons in 86 centres prospectively entered data on 6042 nephrectomies undertaken in 2012. This study is a retrospective analysis of the NSS procedures in the dataset.
1044 NSS procedures. Median surgical volume 4 per consultant (1-39) and 8 per centre (1-59). 36 surgeons and 10 centres reported on only 1 NSS.
elective ≤4. 5cm 59%; elective >4. 5cms 10%; relative 7%; imperative 12%; and VHL 1%; unknown 11%. Median tumour size 3. 4cm (0. 8-30).
Minimally invasive surgery (MIS) 42%, open 58%. Conversions 4%.
Malignant 80%; benign 18%; unknown 2%. Risk factors for benign histology: age
Poor reporting of renal function data. No data on tumour complexity.
In its first year, mandatory national reporting has provided several challenging contemporary insights into NSS. This article is protected by copyright. All rights reserved.
BJU international. 2015 Oct 15 [Epub ahead of print]
Archie Fernando, Sarah Fowler, Tim O'Brien, British Association of Urological Surgeons (BAUS)
British Association of Urological Surgeons, Guy's & St Thomas' NHS Foundation Trust, London, UK. , British Association of Urological Surgeons, Guy's & St Thomas' NHS Foundation Trust, London, UK. , British Association of Urological Surgeons, Guy's & St Thomas' NHS Foundation Trust, London, UK.