ALGORITHM OF PREOPERATIVE EXAMINATION AND METHODS OF SURGICAL TREATMENT OF PATIENTS WITH LOCALIZED KIDNEY CANCER


Dumanskiy1, R. Molchanov2, A. Maltsev3, S.Reshetniak3

1 RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, National Academy of Sciences of Ukraine, Kyiv,
2 Dnipro State Medical University, Dnipro,
3 Educational and Scientific Medical Center “University Clinic”, Kharkiv, Ukraine

DOI: https://doi.org/10.15407/oncology.2023.03.229

 

Summary. Aim: to improve the effectiveness of surgical treatment of patients with localized renal cell carcinoma by improving the assessment of the location of the tumor at the preoperative stage, a thorough study of the vascular anatomy of the kidney and its relation to the tumor, and performing more effective and functionally sparing organ-preserving surgery. Results: based on a multifactorial comparative analysis of the studied criteria that influenced the effectiveness of treatment of patients with localized renal cell carcinoma (RCC) (T1-2vN0M0) we developed an algorithm for preoperative examination and a method of surgical treatment of tumorous lesions of the kidney, which provides a clear understanding of the vascular anatomy of the kidney, taking into account the possible variability of the organ’s angioarchitecture; rational surgical access; close proximity to the area of surgical interest; no need for lateral mobilization of the colon, which is impossible with transabdominal access absence of intraoperative renal ischemia; minimal probability of positive surgical margins; reliable hemostasis; no probability of postoperative trocar circles; satisfactory postoperative cosmetic effect.

 

References

  1. Herr HW. Surgical management of renal tumors: a historical perspective. Urol Clin North Am 2008; 35 (4): 543–9. doi: 10.1016/j.ucl.2008.07.010.
  2. Kerbl DC, McDougall EM, Clayman RV, Mucksavage P. A history and evolution of laparoscopic nephrectomy: perspectives from the past and future directions in the surgical management of renal tumors. J Urol 2011; 185 (3): 1150–4. doi: 10.1016/j.juro.2010.10.040.
  3. Rincon Mayans A, Rioja Zuazu J, Parra RO. From open to robotic partial nephrectomy. Arch Esp Urol 2013; 66 (1): 115–21.
  4. Rouprêt M, Babjuk M, Burger M, et al. European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: 2020 Update. Eur Urol 2021;79 (1): 62–79. doi: 10.1016/j.eururo.2020.05.042.
  5. Campbell S, Uzzo RG, Allaf ME, et al. Renal mass and localized renal cancer: AUA Guideline. J Urol 2017; 198 (3): 520–9. doi: 10.1016/j.juro.2017.04.100.
  6. Ward RD, Tanaka H, Campbell SC, Remer EM. 2017 AUA Renal Mass and Localized Renal Cancer Guidelines: Imaging Implications. Radiographics 2018; 38 (7): 2021–33. doi: 10.1148/rg.2018180127.
  7. Millan B, Breau RH, Bhindi B, et al. A comparison of percutaneous ablation therapy to partial nephrectomy for cT1a renal cancers: Results from the Canadian Kidney Cancer Information System. J Urol 2022; 208 (4): 804–12. doi: 10.1097/JU.0000000000002798.

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