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Elektive organerhaltende Nierentumorchirurgie bei normaler Gegenniere

Langzeitergebnisse

Elective organ-sparing surgery for renal tumors in patients with a normal contralateral kidney

Long-term results

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Zusammenfassung

Im Zuge der ständig sich verbessernden radiologischen Diagnostik werden immer häufiger Nierentumoren inzidentell diagnostiziert. Der Anteil der kleinen Tumoren (≤4 cm, T1a) ist hierbei mit ca. 60% am größten. Die Trias bestehend aus palpablem Tumor, Schmerzen und Makrohämaturie tritt glücklicherweise immer seltener auf. Langzeitfolgen nach Tumornephrektomie wie z. B. Entwicklung einer Niereninsuffienz führten zur ständigen Verbesserung organerhaltender chirurgischer Verfahren bei Patienten mit kleinen unilateralen Tumoren bei gesunder Gegenniere (elektive Indikation). Die nierenerhaltende Chirurgie hat sich zum Goldstandard der Therapie für kleine Nierentumoren entwickelt. Neuere Erkenntnisse über die onkologischen Langzeitergebnisse lassen schließen, dass auch sorgfältig selektionierte Patienten mit unilateralen Nierentumoren >4 cm organerhaltend operiert werden können. Wir berichten im Folgenden über unsere onkologischen Langzeitergebnisse der organerhaltenden Nierentumorchirurgie bei Patienten mit elektiver Indikationsstellung.

Abstract

Continuous improvements in radiological imaging techniques have enabled an earlier diagnosis of incidental renal tumors. The share of small renal tumors (≤4 cm, T1a) amongst the incidentally detected renal masses is reported to be as high as 60%. Fortunately, the classic clinical triad of pain, hematuria, and a palpable flank mass is nowadays the exception of clinical presentation. Concerns regarding development of chronic renal failure after radical nephrectomy have resulted in an increasing use and steady improvement of organ-sparing surgical techniques for patients with small unilateral renal tumors in the presence of a normal contralateral kidney (elective indication). Nephron-sparing surgery has become the gold standard for treating these small tumors. Newer long-term oncological results have demonstrated that carefully selected patients with unilateral renal tumors >4 cm can also be treated with nephron-sparing surgery. We report in this article our long-term oncological results of nephron-sparing surgery in patients with an elective indication.

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  1. Klinik und Poliklinik für Urologie, Johannes-Gutenberg-Universität Mainz, Langenbeckstraße 1, 55101, Mainz, Deutschland

    F.C. Roos, S. Pahernik, W. Brenner & J.W. Thüroff

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  1. F.C. Roos
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  2. S. Pahernik
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  3. W. Brenner
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  4. J.W. Thüroff
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Correspondence to F.C. Roos.

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Roos, F., Pahernik, S., Brenner, W. et al. Elektive organerhaltende Nierentumorchirurgie bei normaler Gegenniere. Urologe 47, 824–829 (2008). https://doi.org/10.1007/s00120-008-1713-6

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