Partial Nephrectomy in Central Renal Tumors

Journal of Endourology
Sohrab Arora, Craig G Rogers

Abstract

Nephron-sparing surgery, especially through a minimally invasive approach, is increasingly being performed for incidentally detected renal masses with excellent outcomes. Tumors in central location remain a surgical challenge during nephron-sparing surgery. In this chapter, we discuss the minimally invasive management of these tumors, which include complex hilar tumors and endophytic central tumors, with a focus on surgical technique. The key to management of these tumors is to maintain good preoperative hydration, achieving adequate exposure of tumor, and the use of intraoperative ultrasound to plan the resection plane. Individual vessels may be ligated as they enter close to the tumor. Careful renorrhaphy is essential, especially in hilar tumors, which have major blood vessels at the base of the tumor. Selective use of near infrared fluorescence imaging, on-demand ischemia, early unclamping, enucleoresection techniques, and intracorporeal hypothermia may help minimize, or reduce the effect of warm ischemia.

References

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Dec 18, 2007·The Journal of Urology·Mike M Nguyen, Inderbir S Gill
Sep 24, 2008·International Journal of Urology : Official Journal of the Japanese Urological Association·Takahiro NoharaMikio Namiki
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Citations

Jan 25, 2019·Journal of Endourology
Feb 15, 2020·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Satoru KiraMasayuki Takeda
Jan 24, 2019·Therapeutic Advances in Urology·Natalie R SwavelyRiccardo Autorino
Mar 25, 2019·International Urology and Nephrology·Ram A Pathak, Ashok K Hemal
Nov 22, 2020·The Urologic Clinics of North America·Laura BukavinaLee Ponsky
Oct 9, 2021·Current Urology Reports·P MacekA R Rodriguez

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Methods Mentioned

BETA
dissection
fluorescence imaging

Software Mentioned

TilePro

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