Tumor enucleation for small renal masses.

Abstract:

PURPOSE OF REVIEW:The incidence of renal cell carcinoma and the detection of incidental small renal masses are rising. Urologists are faced with difficult management decisions on how to treat patients with small renal masses. Traditionally, the treatment of suspicious renal masses was radical nephrectomy. However, nephron-sparing surgery is the standard of care, when possible, because of the risk of renal insufficiency associated with radical nephrectomy. RECENT FINDINGS:A large breadth of data have shown that partial nephrectomy has equivalent oncologic outcomes compared to radical nephrectomy. Recently, attempts to further spare renal parenchyma and perform nephron-sparing surgery in anatomically difficult scenarios have led to the development of the enucleation technique. Enucleation is performed by following the natural plane between the peritumor pseudocapsule and the renal parenchyma. This emerging technique was met with skepticism and concern for incomplete tumor removal. However, studies comparing enucleation and partial nephrectomy to date have revealed equivalent oncologic outcomes. SUMMARY:There has been a greater acceptance of tumor enucleation as a safe alternative for renal masses which are locally confined on preoperative imaging, easily delineated intraoperatively, and do not appear to grossly invade beyond the pseudocapsule.

journal_name

Curr Opin Urol

authors

Laryngakis NA,Guzzo TJ

doi

10.1097/MOU.0b013e3283551f84

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

365-71

issue

5

eissn

0963-0643

issn

1473-6586

journal_volume

22

pub_type

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