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Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

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Nephron-sparing surgery for renal tumors.

Abd El Hamid H Ezzat¹, Ahmed Helmy, Ashraf H Ibrahim

¹Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt. hamidezzat@hotmail.com

Journal of the Egyptian National Cancer Institute

|November 22, 2011

Summary

Nephron sparing surgery (NSS) is a safe and feasible procedure for managing renal tumors, including Wilm's tumor and renal cell carcinoma (RCC). This approach offers a good solution for bilateral tumors and early localized RCC, with acceptable complication rates.

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Published on: July 3, 2013

Area of Science:

Urology
Oncology
Surgical Pathology

Background:

Renal tumors encompass a range of benign and malignant conditions.
Nephron sparing surgery (NSS) is an alternative to radical nephrectomy for selected renal masses.
Evaluating the safety and efficacy of NSS is crucial for patient outcomes.

Purpose of the Study:

To document the National Cancer Institute's (NCI) experience with nephron sparing surgery (NSS) for diverse renal tumors.
To assess the safety and feasibility of NSS in managing benign and malignant renal neoplasms.
To analyze outcomes for patients undergoing NSS for conditions including Wilm's tumor and renal cell carcinoma (RCC).

Main Methods:

A literature review on NSS was conducted.
Patient records of 15 individuals who underwent NSS between 2000 and 2009 at NCI-Cairo University were retrospectively reviewed.
Data collected included tumor characteristics, surgical indications, techniques, complications, histopathology, and follow-up results.

Main Results:

The study included 15 patients with a median age of 32 years, presenting with various renal tumors (Wilm's tumor, angiomyolipoma, RCC, Hydatid cyst).
Indications for NSS included absolute (6 patients), relative (6 patients), and elective (3 patients); 5 patients had bilateral tumors.
Complications were minimal (2 patients), with negative surgical margins achieved in all cases. No local recurrence or metastasis was observed in RCC patients during follow-up.

Conclusions:

Nephron sparing surgery (NSS) is a safe and feasible surgical option for renal tumors.
NSS demonstrates acceptable complication rates and provides effective management for bilateral tumors and early-stage localized renal cell carcinoma (RCC).
Maintaining normal kidney function post-surgery and during follow-up highlights the benefits of NSS.