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nephron sparing surgery

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https://www.readbyqxmd.com/read/28741377/renal-cell-carcinoma-alternative-nephron-sparing-treatment-options-for-small-renal-masses-a-systematic-review
#1
Fieke M Prins, Linda G W Kerkmeijer, Anne A Pronk, Evert-Jan P A Vonken, Richard P Meijer, Axel Bex, Maurits M Barendrecht
<i>Background</i> The standard treatment of T1 renal cell carcinoma is (partial-) nephrectomy. For patients where surgery is not the treatment of choice, for example in the elderly, in case of severe comorbidity, inoperability or refusal of surgery, alternative treatment options are available. These treatment options include active surveillance, radiofrequency ablation, cryoablation, microwave ablation or stereotactic body radiotherapy. In the present overview, the efficacy, safety and outcome of these different options are summarized, particularly focusing on recent developments...
July 25, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28739404/laparoscopic-partial-nephrectomy-with-sequential-precise-tumor-specific-segmental-renal-artery-clamping-for-multiple-ipsilateral-renal-tumors-a-new-treatment-approach-and-initial-experience
#2
Mingyue Tan, Yongzhi Xu, Dongliang Xu, Juntao Jiang, Wei Zhao, Di Cui, Yuan Ruan, Shujie Xia
OBJECTIVE: To present our surgical approach and initial experience of laparoscopic partial nephrectomy (LPN) with sequential precise tumor-specific segmental renal artery clamping in patients with multiple ipsilateral renal tumors. MATERIALS AND METHODS: Six patients with multiple ipsilateral renal tumors having imperative indications for nephron-sparing surgery underwent LPN with sequential precise tumor-specific segmental renal artery clamping from May 2012 to September 2015...
July 21, 2017: Urology
https://www.readbyqxmd.com/read/28731925/thoracic-paravertebral-block-for-postoperative-pain-management-after-renal-surgery-a-randomised-controlled-trial
#3
Maja Copik, Szymon Bialka, Andrzej Daszkiewicz, Hanna Misiolek
BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A prospective, randomised, open label study. SETTING: A single university hospital...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28723695/renoprotective-procedures-with-a-cold-ischemia-time-of-60-min-minimize-the-deterioration-of-kidney-function-in-open-nephron-sparing-surgery-for-renal-cell-carcinoma
#4
Hayato Nishida, Atsushi Yamagishi, Mayu Yagi, Hidenori Kanno, Yuta Kurota, Toshihiko Sakurai, Sei Naito, Tomohiro Shibasaki, Hisashi Kawazoe, Osamu Ichiyanagi, Tomoyuki Kato, Akira Nagaoka, Yoshihiko Tomita, Norihiko Tsuchiya
INTRODUCTION: We evaluated whether nephron sparing surgery (NSS) combined with meticulous suturing of the cut stump under clamping with cooling is beneficial for oncological outcomes and also assessed the relationship between cold ischemia time and deterioration of renal function. METHODS: One hundred and six patients with renal cell carcinoma (RCC) were subjected to this procedure. Oncological outcomes and renal function according to the estimated glomerular filtration rate (eGFR) and the tubular excretion rate on renoscintigraphy before and at 12 months after surgery were evaluated...
July 20, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28723503/nephron-sparing-for-renal-cell-carcinoma-whenever-possible
#5
Hendrik Van Poppel, Steven Joniau, Maarten Albersen
Open studies have definitely and repeatedly favoured nephron-sparing surgery in improving overall, cancer-specific, and cardiac disease-specific survival in cases with a normal contralateral kidney. However, the only randomised clinical trial could not confirm this superiority of nephron-sparing surgery over radical nephrectomy.
December 15, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28723485/three-dimensional-printing-for-renal-cancer-and-surgical-planning
#6
Mary E Westerman, Jane M Matsumoto, Jonathan M Morris, Bradley C Leibovich
Three-dimensional (3D) stereolithographic models provide tactile and anatomic information that offers advantages over digital 3D reconstructions alone. This technology has the potential to alter preoperative surgical planning and significantly enhance successful performance of complex nephron-sparing surgery.
December 15, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28717275/initial-experience-of-robotic-nephron-sparing-surgery-in-cases-of-high-renal-nephrometry-scores
#7
Girdhar S Bora, Ravimohan S Mavuduru, Aditya P Sharma, Sudheer K Devana, Nandita Kakkar, Anupam Lal, Shrawan K Singh, Arup K Mandal
INTRODUCTION: The renal nephrometry scoring (RNS) system enables prediction the feasibility of nephron-sparing surgery (NSS) in renal masses. There is insufficient data regarding the outcome of robot-assisted NSS in tumors with RNS ≥10. We reviewed the trifecta outcomes of patients undergoing robotic NSS with high RNS and compare it with tumors of low and intermediate RNS. MATERIALS AND METHODS: Our prospectively maintained data of all robot-assisted NSS were reviewed, and those with RNS of ≥10 were identified...
July 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28717119/nephron-sparing-surgery-has-better-oncologic-outcomes-than-extirpative-nephrectomy-in-t1a-but-not-in-t1b-or-t2-stage-renal-cell-carcinoma
#8
You Luo, San-San Chen, Liang Bai, Li Luo, Xiang-Guang Zheng, Sen Wang
BACKGROUND The aim of this study was to investigate the benefit of nephron sparing surgery (NSS) compared with extirpative nephrectomy in different tumor stages of renal cell carcinoma. MATERIAL AND METHODS We reviewed the Surveillance, Epidemiology and End Results (SEER) database for NSS and extirpative nephrectomy in localized (stages T1-2N0M0) renal cell carcinoma diagnosed after 2004. We used the variable screening function of the SEER database to identified 55,947 cases that met inclusion and exclusion criteria for survival analysis...
July 18, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28664237/surgical-and-minimally-invasive-therapies-for-the-management-of-the-small-renal-mass
#9
REVIEW
John Withington, Joana B Neves, Ravi Barod
PURPOSE OF REVIEW: This article aims to summarise recent developments in surgical and minimally invasive therapies in the management of small renal masses (SRMs). RECENT FINDINGS: The incidence of the small renal mass is increasing. Standard management of the SRM is partial nephrectomy. More recently, use of ablative techniques to manage the SRM has been increasing and an exciting array of technical advances is currently being made in the field. Nephron-sparing surgery looks set to become more financially viable with the advent of newer robotic platforms and, potentially, even less invasive with the evaluation of single-port access...
August 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28651424/estimated-glomerular-filtration-rate-renal-scan-and-volumetric-assessment-of-the-kidney-before-and-after-partial-nephrectomy-a-review-of-the-current-literature
#10
Riccardo G Bertolo, Homayoun Zargar, Riccardo Autorino, Cristian Fiori, Jihad H Kaouk, Paul Russo, Robert H Thompson, Francesco Porpiglia
INTRODUCTION: The best method for assessing renal function after partial nephrectomy (PN) continues to be a matter of debate. Early studies evaluated kidney function by measuring serum creatinine (sCr) and/or the estimated glomerular filtration rate (eGFR), potentially underestimating the contribution of the contralateral kidney in masking alterations in renal function. Since then, researchers have studied the operated renal unit with the aid of nuclear renal scans (RS). However, taking into consideration the importance of the amount of renal parenchyma spared or sacrificed during PN, many novel methods have been proposed for determining kidney volume before and after PN...
June 23, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28644132/risk-of-acute-myocardial-infarction-in-upper-tract-urothelial-carcinoma-patients-receiving-radical-nephroureterectomy-a-population-based-cohort-study
#11
Shih-Yi Lin, Cheng-Li Lin, Chao-Hsiang Chang, His-Chin Wu, I-Kuan Wang, Che-Yi Chou, Ji-An Liang
BACKGROUND: The outcomes of upper tract urothelial carcinoma (UTUC) receiving radical nephroureterectomy were usually limited to small sample size, case-control studies, and often focused on cancer progression. Risk of acute myocardial infarction (AMI) in these patients was never investigated. RESULTS: The overall incidences of AMI were 3.39, 1.44, and 1.70 per 10,000 person-years in the radical nephroureterectomy, nonnephroureterectomy, and non-UTUC cohorts, respectively...
June 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28620463/recent-advances-in-the-management-of-wilms-tumor
#12
REVIEW
Roberto I Lopes, Armando Lorenzo
The objective of this article is to present an overview of recent trends in the management of Wilms' tumor. With improved survival rates in the past few decades, critical long-term adverse therapy effects (such as renal insufficiency, secondary malignancies, and heart failure) and prevention measures (i.e. nephron-sparing surgery and minimizing the use of radiotherapy) have gained worldwide attention. Specific disease biomarkers that could help stratify high-risk from low-risk patients, and therefore fine-tune management, are in great demand...
2017: F1000Research
https://www.readbyqxmd.com/read/28592625/current-clinical-practice-guidelines-for-the-treatment-of-renal-cell-carcinoma-a-systematic-review-and-critical-evaluation
#13
Aristotle Bamias, Bernard Escudier, Cora N Sternberg, Flora Zagouri, Athanasios Dellis, Bob Djavan, Kimon Tzannis, Loukas Kontovinis, Konstantinos Stravodimos, Athanasios Papatsoris, Dionysios Mitropoulos, Charalampos Deliveliotis, Meletios-Athanasios Dimopoulos, Constantine A Constantinides
The landscape of local and systemic therapy of renal cell carcinoma (RCC) is rapidly changing. The increase in the incidental finding of small renal tumors has increased the application of nephron-sparing procedures, while ten novel agents targeting the vascular endothelial growth factor (VEGF) or the mammalian target of rapamycin pathways, or inhibiting the interaction of the programmed death 1 receptor with its ligand, have been approved since 2006 and have dramatically improved the prognosis of metastatic RCC (mRCC)...
June 2017: Oncologist
https://www.readbyqxmd.com/read/28576587/-is-nephron-sparing-surgery-relevant-for-unilateral-wilms-tumors
#14
T Tricard, I Lacreuse, V Louis, A Schneider, Y Chaussy, L Soler, R Moog, H Lang, D Jacqmin, F Becmeur
BACKGROUND: Wilms tumors (WTs) are the most frequent renal tumors in children. Radical nephrectomy (RN) remains the gold-standard surgical treatment for this type of cancer. Excellent results in overall survival (>90%) make it possible to consider nephronic preservation. The objective of this systematic review is to evaluate the relevance of nephron-sparing surgery (NSS) for the treatment of nonsyndromic unilateral Wilms tumor (UWT) in children. METHODS: Articles in English related to "unilateral Wilms tumor, unilateral nephroblastoma, partial nephrectomy, nephron-sparing surgery, renal function" identified in the Medline library were screened and data were extracted to perform a qualitative systematic review...
July 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28546710/current-status-of-nephron-sparing-surgery-nss-in-the-management-of-renal-tumours
#15
REVIEW
Vivek Venkatramani, Sanjaya Swain, Ramgopal Satyanarayana, Dipen J Parekh
Nephron-sparing surgery has emerged as the surgical treatment of choice for small renal masses over the past two decades, replacing the traditional teaching of radical nephrectomy for renal cell carcinoma. With time, there has been an evolution in the techniques and indications for partial nephrectomy. This review summarizes the current status of nephron-sparing surgery for renal carcinoma and also deals with the future of this procedure.
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28527565/-advancement-in-the-treatment-of-renal-carcinoma
#16
Arnaud Méjean
Partial nephrectomy is the gold standard for the renal tumours less than 7 to 10cm whenever feasible in order to preserve renal function. The extension of nephron-sparing surgery using a mini-invasive approach is possible by robotic surgery. Radical nephrectomy is mandatory in the other situations and especially in case of locally advanced renal carcinoma. The place of cytoreductive nephrectomy in metastatic renal cell carcinoma is the purpose of the CARMENA trial. Tyrosine kinase inhibitors are currently the first line treatment; but in the near future new immunotherapy by checkpoints molecules could crucially change the treatment of metastatic renal cell carcinoma...
May 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28516188/management-of-bilateral-wilms-tumours
#17
REVIEW
Alastair J W Millar, Sharon Cox, Alan Davidson
Wilms tumour is named after Max Wilms. It is an embryonal tumour derived from the metanephros. It is the commonest childhood renal tumour and the third commonest paediatric malignancy. Synchronous bilateral Wilms tumours (BWT) represent 4-7% of all Wilms tumours (WT) and present at a younger age than unilateral Wilms tumours. At least 10% of synchronous BWTs have unfavourable histology, and up to 22% are associated with genitourinary abnormalities, aniridia, WAGR syndrome, Denys-Drash syndrome, hemihypertrophy, or one of the other overgrowth syndromes...
May 17, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28483780/renal-functional-outcomes-after-surgery-ablation-and-active-surveillance-of-localized-renal-tumors-a-systematic-review-and-meta-analysis
#18
Hiten D Patel, Phillip M Pierorazio, Michael H Johnson, Ritu Sharma, Emmanuel Iyoha, Mohamad E Allaf, Eric B Bass, Stephen M Sozio
BACKGROUND AND OBJECTIVES: Management strategies for localized renal masses suspicious for renal cell carcinoma include radical nephrectomy, partial nephrectomy, thermal ablation, and active surveillance. Given favorable survival outcomes across strategies, renal preservation is often of paramount concern. To inform clinical decision making, we performed a systematic review and meta-analysis of studies comparing renal functional outcomes for radical nephrectomy, partial nephrectomy, thermal ablation, and active surveillance...
July 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28462169/managing-renal-cell-carcinoma-associated-paraneoplastic-syndrome-with-nephron-sparing-surgery-in-a-patient-with-von-hippel-lindau
#19
John M DiBianco, Julie Y An, Sally Tanakchi, Zachary Stanik, Aidan McGowan, Mahir Maruf, Abhinav Sidana, Amit Lodha Jain, Akhil Muthigi, Arvin K George, Christopher Bayne, W Marston Linehan, Shawna L Boyle, Adam R Metwalli
A patient with germline von Hippel-Lindau (VHL) gene alteration and history of multiple tumors present with classical paraneoplastic syndrome (PNS) associated with renal cell carcinoma (RCC). She underwent open nephron sparing surgery with resolution of symptoms. She remained without recurrence of RCC for the initial 2 years of her follow-up. To the best of our knowledge, this case represents the first in which PNS was specifically resolved using a partial nephrectomy in a patient with VHL. This case report provides initial evidence for the potential role of nephron sparing surgery in the management of paraneoplastic symptoms associated with hereditary RCC...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28452170/trends-in-the-surgical-management-of-stage-1-renal-cell-carcinoma-findings-from-a-population-based-study
#20
V White, D J T Marco, D Bolton, I D Davis, M Jefford, D Hill, H M Prince, J L Millar, I M Winship, M Coory, G G Giles
OBJECTIVES: To determine whether use of nephron sparing surgery (NSS) for treatment of stage 1 renal cell carcinomas changed between 2009 and end 2013 in Australia. PATIENTS AND METHODS: All adult cases of renal cell carcinoma diagnosed in 2009, 2012, and 2013 were identified through the population-based Victorian Cancer Registry. For each identified patient, trained data-abstractors attended treating hospitals or clinician rooms to extract tumour and treatment data through medical record review...
April 28, 2017: BJU International
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