Postchemotherapy excision of the tumor is indicated in patients with bilateral tumors, tumors that extended beyond the midline and have shrunk, and tumors with vascular extension. (medscape.com)
Contraindications to primary surgery for Wilms tumor include bilateral tumors and documented metastatic disease. (medscape.com)
Large tumors that extend beyond the midline, have vascular extension, or both are relative contraindications, since some surgeons elect to obtain tissue via surgical excision, but this may expose patients to increased surgical risks. (medscape.com)
In patients with bilateral Wilms tumors, solitary kidney, or kidney insufficiency, partial nephrectomy is a reasonable consideration. (medscape.com)
2004) Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. (medscape.org)
2003) Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumors in 200 patients. (medscape.org)
2007) Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. (medscape.org)
Vermooten V (1950) Indications for conservative surgery in certain renal tumors: a study based on the growth pattern of the cell carcinoma. (medscape.org)
Partial nephrectomy may be feasible in only 10%-15% of patients, as most tumors are too large at initial diagnosis. (medscape.com)
3] In the presence of bilateral Wilms tumors, solitary kidney, or renal insufficiency, partial nephrectomy is a reasonable consideration. (medscape.com)
Indications for unilateral nephrectomy include unilateral tumors, living kidney donation, severe unilateral kidney trauma, recurrent pyelonephritis in a refluxing non- or minimally-functioning kidney, atrophic kidney, and in the setting of a non-functioning, dysplastic kidney resulting in severe hypertension (HTN). (kireportscommunity.org)
These tumors corresponds to renal cell carcinoma (RCC) stage T1a. (e-urol-sci.com)
[3] These tumors also exhibit excellent prognostic outcome following surgery, with 98%-100% 3-year metastases-free survival rate. (e-urol-sci.com)
Although renal tumors are primarily detected on various imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound, they do not offer a definitive diagnosis. (e-urol-sci.com)
Especially during excision of large tumors, sometimes 12 th rib has also to be removed through the same incision. (tibeterdogru.com)
But in terms of efficiency, there is not a significant difference between Radical Nephrectomy (which is total removal of kidney) and Robotic Surgery or Conventional Laparoscopic Surgery performed for kidney tumors. (tibeterdogru.com)
The main surgery during which Robotic Surgery technique provides especially technical advantage is Nephron Sparing Surgery for Renal Tumors, which is also called Partial Nephrectomy or Nephron-Sparing Renal Tumor Excision. (tibeterdogru.com)
This technique can be used especially for renal tumors that are 4cm or smaller in diameter, depending on their locations in kidney. (tibeterdogru.com)
The standard practice in localized kidney tumors that can be operated with organ (kidney) sparing surgery technique is the open partial nephrectomy. (tibeterdogru.com)
As these patients frequently harbor bilateral or multifocal tumors, the management of renal masses is still under debate. (bvsalud.org)
Radical nephrectomy is the standard treatment for post-transplant renal tumors of the native kidneys in KT recipients, with laparoscopic techniques leading to significantly less perioperative complication rates as compared to the open approach. (bvsalud.org)
The classification of epithelial tumors of the kidney has in particular undergone substantial progress in the last two decades with major contributions from genetic typing of renal cell carcinomas (RCCs). (abdominalkey.com)
The role of genotyping and ancillary tools, in particular immunohistochemistry, in correctly classifying these tumors is highlighted in the section on Renal Cell Carcinoma. (abdominalkey.com)
More than 80% of renal tumors of childhood are Wilms tumor (nephroblastoma) ( 1 , 2 ). (abdominalkey.com)
Cell carcinoma14
2007) Patterns of recurrence and surveillance strategies for renal cell carcinoma following surgical resection. (medscape.org)
1999) Nephron sparing surgery for localized renal cell carcinoma: impact of tumor size on patient survival, tumor recurrence and TNM staging. (medscape.org)
2004) Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. (medscape.org)
1994) Expanding indications for conservative renal surgery in renal cell carcinoma. (medscape.org)
2004) Changing concepts in the surgical management of renal cell carcinoma. (medscape.org)
2000) Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. (medscape.org)
2004) Application of TNM, 2002 version, in localized renal cell carcinoma: is it able to predict different cancer-specific survival probability? (medscape.org)
2005) Elective nephron sparing surgery should become standard treatment for small unilateral renal cell carcinoma: long-term survival data of 216 patients. (medscape.org)
2005) Assessment of surgical margins in renal cell carcinoma after nephron sparing: a comparative study: laparoscopy vs open surgery. (medscape.org)
1989) Conservative surgery for renal cell carcinoma: a single-center experience with 100 patients. (medscape.org)
Licht MR and Novick AC (1993) Nephron sparing surgery for renal cell carcinoma. (medscape.org)
1997) Patterns of tumor recurrence and guidelines for followup after nephron sparing surgery for sporadic renal cell carcinoma. (medscape.org)
Small renal masses (SRM) are defined as contrast-enhancing solid masses detected on diagnostic imaging, with a size of less than or equal to 4cm, corresponding to renal cell carcinoma stage T1a. (e-urol-sci.com)
Partial15
Wilms tumor, treatment for which includes surgery (radical or partial nephrectomy), is the fifth most common pediatric malignancy and the most common type of renal tumor in children. (medscape.com)
2004) Laparoscopic partial nephrectomy: evaluation of long-term oncological outcome. (medscape.org)
Lane BR and Gill IS (2007) 5-Year outcomes of laparoscopic partial nephrectomy. (medscape.org)
2002) Does the size of the surgical margin in partial nephrectomy for renal cell cancer really matter? (medscape.org)
2005) Exploring the learning curve, pathological outcomes and perioperative morbidity of laparoscopic partial nephrectomy performed for renal mass. (medscape.org)
1995) Partial nephrectomy: technique, complications and pathological findings. (medscape.org)
Herr HW (1999) Partial nephrectomy for unilateral renal carcinoma and a normal contralateral kidney: 10-year followup. (medscape.org)
These range from conventional radical approaches such as radical nephrectomy, partial nephrectomy, to more conservative approaches such as active surveillance, and some novel emerging management strategies such as various thermal ablation techniques. (e-urol-sci.com)
Image-2: Robotic Partial Nephrectomy - Locations of the small holes opened on anterior abdominal wall during robotic or laparoscopic kidney surgeries. (tibeterdogru.com)
Robotic technology, with the advantages it brought, has an important place in partial (nephron sparing) surgery. (tibeterdogru.com)
Thanks to increasing experience in intracorporeal suturing (suturing and knot-tying inside the body) and advanced laparoscopic vessel devices used during laparoscopic technique, it has become easier to perform partial nephrectomy via laparoscopic technique in selected patients. (tibeterdogru.com)
Wilms11
Wilms tumor is rare in adults, accounting for only 0.5% of renal lesions. (medscape.com)
Gross nephrectomy specimen shows a Wilms tumor pushing the normal renal parenchyma to the side. (medscape.com)
Although the NWTSG/COG and SIOP guidelines concur that combined surgery, chemotherapy and radiotherapy is the initial treatment for Wilms tumor in children, they differ on the preferred strategy for delivery of therapy. (medscape.com)
For unilateral Wilms tumor, the NWTSG/COG guidelines, primarily followed in North America, recommend surgery prior to chemotherapy, whereas the SIOP guidelines, followed in Europe, recommend both preoperative and postoperative chemotherapy. (medscape.com)
Wilms tumor arises from the primitive embryonal renal tissue. (medscape.com)
Grossly, Wilms tumor is typically an intrarenal solid or cystic mass, which may displace and, in rare cases, invade the renal collecting system. (medscape.com)
Wilms tumor is bilateral in 6% of cases. (medscape.com)
Surgery alone is not recommended for Wilms tumor, based on the results of the NWTSG-5 study. (medscape.com)
According to the NWTSG protocol, the first step in the treatment of Wilms tumor is surgical staging followed by radical nephrectomy, if possible. (medscape.com)
New protocols in the management of bilateral Wilms tumor are being explored. (medscape.com)
4, 5, 6] More recently, several authors have recommended the use of a laparoscopic approach in children with Wilms tumor that has favorable histology and has not spread locally or metastasized. (medscape.com)
Unilateral4
Although end-stage kidney disease after unilateral radical nephrectomy is uncommon (0.25% in the NWTSG trial), preserving healthy kidney tissue may prevent this complication, especially in patients with an underlying intrinsic kidney disease (eg, WAGR [Wilms tumor, aniridia, genitourinary anomalies, and mental retardation] syndrome, Denys-Drash syndrome). (medscape.com)
However, there are times when unilateral nephrectomy is undertaken initially to reduce proteinuria while simultaneously preserving residual kidney function. (kireportscommunity.org)
Specifically in children , a unilateral ligation approach was compared to unilateral surgical nephrectomy before KT (indications for which included polyuria, massive resistant proteinuria, intractable HTN, and recurrent kidney infection). (kireportscommunity.org)
Laparoscopy1
7, 8] A complete surgical procedure can be performed by laparoscopy when the tumor is small, allowing a first approach to the renal vessels without mobilization of the kidney. (medscape.com)
Effectiveness of perioperative chemotherapy and radical cystectomy in treating bladder cancer. (moffitt.org)
Kidney14
However, there are circumstances when kidneys do not behave as they should, and nephrectomy is more beneficial than leaving a dysfunctional kidney. (kireportscommunity.org)
Indications for bilateral nephrectomy include autosomal recessive polycystic kidney disease (ARPKD) and autosomal dominant polycystic kidney disease (ADPKD) owing to their large sizes. (kireportscommunity.org)
In order to perform an open nephrectomy (in the language of medicine, total removal of kidney is called nephrectomy), a surgical incision that can reach up to 35-40 cm is being made (Image-1). (tibeterdogru.com)
After USA and European countries, nowadays laparoscopic kidney surgery has become a standard surgical procedure in our country, too. (tibeterdogru.com)
Image-1: Open Nephrectomy - During open kidney surgery, 3 layers of muscle composing abdominal wall are cut through consecutively with a big flank incision. (tibeterdogru.com)
However, thanks to our latest experiences in laparoscopic and robotic surgeries, now we are able to partially excise renal masses that are 6-8 cm in diameter, while preserving the remained healthy part of kidney. (tibeterdogru.com)
CONCLUSIONS: Lithiasis in kidney transplant is a rare condition usually diagnosed after one year after surgery and mostly located in the calyces and renal pelvis, more frequently of calcium oxalate composition. (bvsalud.org)
INTRODUCTION: Kidney transplant (KT) recipients have a four-times higher risk of renal malignancies compared to general population. (bvsalud.org)
Nephron-sparing surgery is not justified for masses in the native kidney. (bvsalud.org)
Concurrent bilateral native nephrectomy at the time of transplantation can be considered in patients with renal mass and polycystic kidney disease, especially if no residual urinary output is present. (bvsalud.org)
Urology2
However, thanks to the technologic advantages offered to urology by daVinci Robot, robotic surgery in treatment of renal cancers has come to the fore. (tibeterdogru.com)
A native of Canada, Dr. Spiess received a master's in experimental urology surgery at McGill University in Montreal and his medical degree from the University of Toronto. (moffitt.org)
Feasible1
SYNTHESIS OF EVIDENCE: In frail patients with renal masses below 3â ¯cm, active surveillance is a feasible alternative. (bvsalud.org)
Masses3
2. Renal artery embolization (RAE) has been described for cases of severe nephrotic syndrome (NS) , renal masses at risk for hemorrhage with resection (i.e., tuberous sclerosis-associated angiomyolipomas), and acute renal hemorrhage associated with trauma. (kireportscommunity.org)
Small renal masses (SRM) are defined as contrast-enhancing solid masses detected on abdominopelvic imaging, with a size of ≤4 cm. (e-urol-sci.com)
Radical nephrectomy is most frequently performed for localized renal masses. (bvsalud.org)
Tumor3
The tumor extends into the renal vein in 40% of cases. (medscape.com)
[6] Therefore, renal mass biopsy (RMB) is necessary to assess the histological type of the tumor, as well as to guide treatment decisions of SRMs. (e-urol-sci.com)
The tumor is usually circumscribed by a pseudocapsule formed of compressed renal and perirenal tissues. (abdominalkey.com)
Kidneys3
Currently, nephrectomies are not performed with Multicystic Dysplastic Kidneys (MCDK). (kireportscommunity.org)
Tiny filtering systems in our kidneys are called nephrons, and each of kidneys contain nearly one million of them. (tibeterdogru.com)
CONCLUSIONS: Post-transplant renal cancer of the native kidneys is a frequent occurrence. (bvsalud.org)
Surgical3
Surgical nephrectomies can be open, laparoscopic, or robot-assisted. (kireportscommunity.org)
The benefits of ureteral ligation over surgical nephrectomy include a less invasive procedure with smaller incisions and less risk for bleeding. (kireportscommunity.org)
There will be long-term pain and numbness around surgical site due to the damage caused to muscles and nerves while making this large surgical incision. (tibeterdogru.com)
Pediatric1
In addition, preliminary but encouraging data indicate that a laparoscopic approach to nephrectomy in benign disease is associated with decreased lengths of hospital stay and analgesic requirements in the pediatric patient. (medscape.com)
Recurrence1
The main concern regarding a nephron-sparing procedure is that of local recurrence. (medscape.com)
Biopsy1
If imaging studies demonstrate bilateral disease, nephrectomy is not performed, but biopsy specimens are obtained. (medscape.com)
Excision1
but now much more complex reconstructive surgeries (excision of unhealthy part, and mending the gap) are being performed. (tibeterdogru.com)
However, thanks to Robotic System our patients can be offered a surgery performed using 10-15 times magnified, 3 dimensional high-definition vision system, and robotic arms which eradicate any hand tremors and can move in many directions like hand. (tibeterdogru.com)
Patients with localized disease and successful radical nephrectomy do not require immunosuppression adjustment. (bvsalud.org)
Outcome1
2007) Morbidity and clinical outcome of nephron-sparing surgery in relation to tumour size and indication. (medscape.org)
Bladder1
Dr. Spiess' research interests include novel therapies for advanced renal, bladder and penile cancer. (moffitt.org)
Congenital Finnish-type nephrotic syndrome is characterized by massive proteinuria, and treatment often involves daily albumin infusions, intensified nutrition, and initial therapy with NSAID and renin-Angiotension-Aldosterone system inhibition (RAASi), thereby reducing proteinuria (aka medical nephrectomy, discussed later). (kireportscommunity.org)
Introduction1
INTRODUCTION: Lithiasis in renal graft recipients might be a dangerous condition with a potential risk of organ function impairment. (bvsalud.org)
Experience1
2000) Laparoscopic versus open radical nephrectomy: a 9-year experience. (medscape.org)