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Chyma that the surgeon is able to preserve. Unfortunately, little information is available on the surgical technique that was used in these patients, especially regarding the thickness of surrounding healthy parenchyma that was resected. During the study period, the surgeons were not aware that the thickness of the surgical margin does not correlate with risk of local recurrence and oncologic outcomes. viagra online overnight delivery usa Therefore, it is likely that nss procedures were performed with preservation of less parenchyma than we would do today. where to buy viagra The only way to estimate parenchymal sacrifice is to assess postoperative renal function. buy soft viagra In this study, however, renal function was estimated only by serum creatinine, which decreases only when there is a 50% reduction in kidney function. took viagra viagra same time More information could be obtained if data on egfr were available. Moreover, it is well known that comorbidities significantly influence overall survival for kidney cancer. http://howtosmudge.com/pjn-discount-viagra-lowest-prices-gf/ In this study, the presence of comorbid disease was only generically reported without using standardized scores. These tools were not available when the study was designed, but their use would have helped confirm a homogeneous distribution of comorbidities in the two treatment groups. This confirmation is essential for the clinical validity of the study results. In summary, the study from van poppel et al provides the first level 1 evidence comparing rn and nss for localized renal tumors, confirming the oncologic efficacy of pn and supporting its widespread use for small renal tumors. viagra reviews by women The authors should be congratulated for their efforts to design and conduct this randomized trial, which probably will not be reproduced based on the current scientific evidence. nationalityinworldhistory.net/bsh-viagra-cheap-online-cs/ However, due to the study limitations, the potential protective role of nss on non-cancer-related mortality and especially cardiovascular mortality remains controversial. Further multicenter prospective studies with accurate assessment of comorbidities and postoperative renal function are needed to clarify this important clinical issue. viagra reviews by women Conflicts of interest the authors have nothing to disclose. Return to article outline references [1] j. J. Patard, o. Shvarts, j. S. viagra shipped to canada Lam, et al.. Safety and efficacy of partial nephrectomy for all t1 tumors based on an international multicenter experience. J urol 171 (2004) (2181 - 2185) crossref. [2] f. Becker, s. is generic viagra safe Siemer, m. Hack, u. Humke, m. generic viagra shipped overnight Ziegler, m. Significance bathtub viagra commercials Stöckle. Excellent long-term cancer control with elective nephron-sparing surgery for selected renal cell carcinomas measuring more than 4 cm. cheap generic viagra india Eur urol 49 (2006) (1058 - 1064) abstract, full-text, pdf, crossref. [3] a. viagra reviews by women S. Go, g. canadian generic viagra M. Chertow, d. buy viagra online usa Fan, c. E. Mcculloch, c. Y. Hsu. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N engl j med 351 (2004) (1296 - 1305) crossref. viagra 50 y 100 [4] w. C. generic viagra fast delivery Huang. Cheap herbal viagra Copyright © Nine Lives Sytems Pty Ltd
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