Renal mass size

Kathrins, Martin; Caesar, Scott; Mucksavage, Phillip; Guzzo, Thomas J.

doi:10.1097/mou.0b013e328363212b

Cited by 13 publications

(3 citation statements)

References 32 publications

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“…In terms of tumor size, studies indicate that CT imaging overestimates pathologic size by a small amount. The size tends to be overestimated small tumors and underestimated for larger tumors [21]. …”

Section: Evidence Synthesismentioning

confidence: 99%

A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy

et al. 2015

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Context A detailed understanding of renal surgical anatomy is necessary to optimize preoperative planning and operative technique and provide a basis for improved outcomes. Objective To evaluate the literature regarding pertinent surgical anatomy of the kidney and related structures, nephrometry scoring systems, and current surgical strategies for partial nephrectomy (PN). Evidence acquisition A literature review was conducted. Evidence synthesis Surgical renal anatomy fundamentally impacts PN surgery. The renal artery divides into anterior and posterior divisions, from which approximately five segmental terminal arteries originate. The renal veins are not terminal. Variations in the vascular and lymphatic channels are common; thus, concurrent lymphadenectomy is not routinely indicated during PN for cT1 renal masses in the setting of clinically negative lymph nodes. Renal-protocol contrast-enhanced computed tomography or magnetic resonance imaging is used for standard imaging. Anatomy-based nephrometry scoring systems allow standardized academic reporting of tumor characteristics and predict PN outcomes (complications, remnant function, possibly histology). Anatomy-based novel surgical approaches may reduce ischemic time during PN; these include early unclamping, segmental clamping, tumor-specific clamping (zero ischemia), and unclamped PN. Cancer cure after PN relies on complete resection, which can be achieved by thin margins. Post-PN renal function is impacted by kidney quality, remnant quantity, and ischemia type and duration. Conclusions Surgical renal anatomy underpins imaging, nephrometry scoring systems, and vascular control techniques that reduce global renal ischemia and may impact post-PN function. A contemporary ideal PN excises the tumor with a thin negative margin, delicately secures the tumor bed to maximize vascularized remnant parenchyma, and minimizes global ischemia to the renal remnant with minimal complications. Patient summary In this report we review renal surgical anatomy. Renal mass imaging allows detailed delineation of the anatomy and vasculature and permits nephrometry scoring, and thus precise, patient-specific surgical planning. Novel off-clamp techniques have been developed that may lead to improved outcomes.

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Section: Evidence Synthesismentioning

confidence: 99%

A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy

et al. 2015

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“…Several articles have already demonstrated that US lacks sensitivity in the evaluation of small renal masses. ( 16 , 17 , 19 ) Interestingly, other tumor features such as laterality, location, growth pattern, BMI and radiology experience did not influence the detection of solid renal nodules on US in our study. We raised the hypothesis that modern US equipment might overcome difficulties in evaluation of intrarrenal lesions, as well as limitations of US performed on obese patients.…”

Section: Discussionmentioning

confidence: 42%

“…Vários artigos já demonstraram que a US tem pouca sensibilidade para avaliação de massas renais pequenas. ( 16 , 17 , 19 ) É interessante que outras características do tumor, como lateralidade, localização, padrão de crescimento, IMC e experiência em radiologia, não influenciaram na detecção de nódulos renas sólidos pela US em nosso estudo. Nossa hipótese é a de que equipamentos modernos de US podem superar dificuldades na avaliação de lesões intrarrenais e, inclusive, limitações da US realizada em pacientes obesos.…”

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A comparative study of ultrasound and cross-sectional imaging for detection of small renal masses: anatomic factors and radiologist's experience

Yamauchi¹,

Paiva²,

Mussi³

et al. 2020

Einstein (São Paulo)

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Multiparametric magnetic resonance imaging for the differentiation of low and high grade clear cell renal carcinoma

et al. 2014

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Renal mass size

Abstract: The differences between radiographic and pathologic size are small. Findings show good efficacy across CT, MRI and ultrasound. This may reduce reliance on CT imaging alone in the future.

Cited by 13 publications

References 32 publications

A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy

A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy

A comparative study of ultrasound and cross-sectional imaging for detection of small renal masses: anatomic factors and radiologist's experience

Multiparametric magnetic resonance imaging for the differentiation of low and high grade clear cell renal carcinoma

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