Konservative Chirurgie des Nierenzellkarzinoms - Technik und Verlauf von 84 Patienten

Schärfe, T.; Thüroff, Joachim W.; Alken, P.; Riedmiller, H.; Jacobi, G.; Hohenfellner, R.

doi:10.1055/s-2008-1061356

Cited by 7 publications

(7 citation statements)

References 9 publications

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“…Ex vivo surgery was avoided because of its increased complication rate (Wickham, 1975). Postoperative complications in the present series, even in older patients, were comparable to those of other conservative surgical series (Carini et al, 1988;Scharfe et al, 1988), although the morbidity rate following a haemorrhage exceeds that of radical surgery (Grayhack, 1983).…”

Section: Discussionsupporting

confidence: 63%

“…Other technical points are a matter of debate. Clamping the hilus with or without hypothermia and bench surgery has been suggested (Wickham, 1975;Marberger et al, 1981;Smith et al, 1984;Novick, 1987) but others have advocated either digital compression of the renal artery (Graham and Glenn, 1979) or in situ surgery without vascular control (Bazeed et al, 1986;Scharfe et al, 1988). We have not used hilar clamping as a rule because secondary arterial thrombosis has been reported (Carini et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

“…Today the choice of treatment, radical as opposed to conservative surgery, is a matter of major concern. Radical nephrectomy, with or without lymph node dissection, has been the treatment of choice, although unexpectedly good results have been achieved with local tumour resection (Graham and Glenn, 1979;Marberger et al, 1981;Smith et al, 1984;Bazeed et al, 1986;Novick et al, 1989;Novick, 1987;Carini et al, 1988;Montie and Novick, 1988;Scharfe et al, 1988;Jung et al, unpublished data).…”

mentioning

confidence: 99%

“…Elective conservative surgery in the presence of a normal contralateral kidney has been severely criticised (Mukamel et al, 1988;Skinner, 1989), although the results of such treatment have been excellent (Carini et al, 1988;Scharfe et al, 1988).…”

mentioning

confidence: 99%

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Is there a Place for Conservative Surgery in the Treatment of Renal Carcinoma?

Poppel

Claes

Willemen

et al. 1991

British Journal of Urology

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Since 1981, 31 patients have undergone conservative surgery for malignant renal tumours and have been followed up for at least 2 years. The techniques included enucleation or resection (wedge resection or partial nephrectomy). In 10 patients the indications for kidney-sparing surgery were absolute, while in the remainder the conservative surgical approach was a deliberate choice. The tumours varied in diameter from 1.3 to 12 cm and no metastases were detected on pre-operative screening. One patient died post-operatively from myocardial infarction. In the remaining 30 there were no local recurrences. Two patients died from skeletal metastases (1 with bilateral malignancy) and 2 underwent surgery in the post-operative period for haemorrhagic complications. The efficacy of conservative surgery in the local control of renal cancer is an argument in favour of its wider use.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Is there a Place for Conservative Surgery in the Treatment of Renal Carcinoma?

Poppel

Claes

Willemen

et al. 1991

British Journal of Urology

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“…= 1/3 mm) angiography catheter [4]. Radical tumor extirpation is of importance for prognosis [3,33,36,37,39,44]. Beside this an intraoperative last decision is possible whether to use this organ-protective measurement or not and to avoid a reduced blood perfusion of the kidney during its preparation by the catheter.…”

Section: Discussionmentioning

confidence: 99%

A new method for conservative renal surgery ? experimental and first clinical results

Kallerhoff

Blech

Götz

et al. 1990

Langenbecks Arch Chir

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So far two methods for prolonging the tolerance of renal ischemia are available: 1) surface cooling with crushed ice and 2) perfusion cooling with an extracellular-like solution. Both methods use only the principle of reducing metabolism through cooling. While rewarming during surgery the ischemic protection is lost, or the kidney must be cooled once again. Therefore, a new preservation solution should reduce energy consumption due to its composition in addition to cooling. For open heart surgery, the HTK solution by Bretschneider is already used clinically. In 71 dog kidney experiments, the ischemic time kidneys could tolerate was prolonged by this solution from 15 to 120 min at 35 degrees C and from 45 to 360 min at 25 degrees C. After 2 h of ischemia at 30 degrees C glomerular filtration rate was about 20 ml/min.100gww within 3 h of reperfusion. After six postoperative days the filtration rate was 40 ml/min.100 gww. No ischemic damage could be recognized by histological investigations. The clinical effectiveness of this method was shown in 7 clinical applications. Ischemic duration lasted up to 113 min, and blood creatinine was between 0.8 and 2.4 mg% at the 6th postoperative day. Use of this preservation technique thus leads to improved kidney function immediately following operation. Longer ischemia can be tolerated by a kidney thus protected, and using this technique excellent visibility can be achieved during intrarenal surgery, simplifying, for example, tumor extirpation.

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Nephron-Sparing Surgery

Poppel

Baert

1999

Carcinoma of the Kidney and Testis, and Rare Urologic Malignancies

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Konservative Chirurgie des Nierenzellkarzinoms - Technik und Verlauf von 84 Patienten

Cited by 7 publications

References 9 publications

Is there a Place for Conservative Surgery in the Treatment of Renal Carcinoma?

Is there a Place for Conservative Surgery in the Treatment of Renal Carcinoma?

A new method for conservative renal surgery ? experimental and first clinical results

Nephron-Sparing Surgery

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