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Is it possible to remove a kidney tumor while preserving the organ?

How effective and safe is kidney resection?

Wouldn't it be better to completely remove the kidney affected by the cancerous tumor, considering it's a paired organ?

When is it necessary to perform kidney tumor resection while preserving the organ?

What should be chosen: open or laparoscopic kidney resection?

What are the advantages of performing kidney tumor resection at the Dilyanian Clinical Center?

— Please tell us, is it possible to remove a kidney tumor while preserving the affected organ?

— Removal of a kidney tumor, or kidney resection, is entirely possible. Whenever a patient with a kidney tumor comes to us, we discuss the possibility of kidney preservation, as large European studies have demonstrated the effectiveness of this approach.

Laparoscopic kidney resection

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play icon Laparoscopic kidney resection

The "gold standard" treatment for kidney tumors, especially in the early stages, is the removal of the tumor while preserving the organ. Modern laparoscopic technology allows this operation to be performed without incisions, significant scarring, or the need for lengthy rehabilitation, which is typical of open surgeries.

— How effective and safe is kidney tumor removal for the patient? Wouldn't it be better to remove the kidney affected by the cancerous tumor, considering it's a paired organ?

— Indeed, kidney removal is still the "gold standard" treatment for kidney cancer in many cases. However, several factors need to be considered: studies have shown that in the early stages of kidney cancer, resection is as radical as nephrectomy (kidney removal). If organ preservation is technically feasible, why subject the patient to potential problems?

Moreover, the patient's other kidney may be affected by conditions such as kidney stones, posing a risk of kidney function loss and lifelong dialysis. Therefore, whenever patients with kidney tumors come to us, we primarily evaluate the possibility and safety of organ-preserving treatment.

— In which cases do you lean towards kidney tumor resection?

— According to the recommendations of the European Association of Urology, kidney resection should be performed for patients with tumor size not exceeding 7 cm. Other important factors include tumor spread to lymph nodes, tumor thrombus in the renal or inferior vena cava, and distant metastases. The presence of at least one of these factors indicates a preference for kidney removal.

It is also worth noting that in some cases, the kidney tumor may be small but located near the renal artery or vein. In this case, unfortunately, kidney preservation is not possible.

— It is known that in your center, most patients are offered laparoscopic kidney resection. Why not for everyone?

— Let's clarify.

Laparoscopic surgery allows for surgery without a large incision– the procedure is performed through several small incisions using special instruments and a camera that displays the image on a screen. Patients can be discharged home after three to four days: there is no risk of inflammation, no postoperative pain, and no hernia formation. Excellent visualization, with the operating field magnified up to 10 times, allows for very precise kidney resection with minimal blood loss.

However, in some cases, patients have relative or absolute contraindications to laparoscopic access. For example, we operated on a patient who had undergone 7 surgeries on abdominal organs before. Clearly, he would have adhesions, and laparoscopic surgery, despite all its advantages, would become "surgery for the sake of surgery" with a greater risk to the patient. Yes, we widely use minimally invasive, low-trauma surgery, but, unfortunately, there are cases where we understand that open surgery is better. Fortunately, these cases are quite rare.

Comparison of open and laparoscopic methods

Minimally invasive surgery or the aim to avoid unnecessary surgical trauma is a modern concept in surgery, fully in line with the main principle of surgery "Do no harm". It may seem that for the removal of a small tumor during open surgery, a 20-25 cm incision of the skin, muscles, and fascia is required. Throughout the operation, this wound is exposed to the influence of the external environment and contamination by bacteria. The incision leads to pain, inflammation, significant scarring, and may result in hernias that are difficult to treat.

Laparoscopy, on the other hand, where access to the tumor is achieved through three or four minor incisions, is completely free of these drawbacks.

Watch the video comparing open and laparoscopic kidney resection at this LINK.

— There are quite a few clinics where kidney resection is performed.

What are the advantages of the Dilyanian Clinic?

— I would first of all mention teamwork. For each patient, we hold a consultation where we discuss the safety and effectiveness of various interventions. Our clinic has implemented the European "gold standard" of comprehensive evaluation, minimizing postoperative complications.

It is also worth notingthat our operating rooms are equipped with instruments and equipment from recognized German and Japanese leaders such as Karl Storz and Olympus, and the anesthesiology support is at the highest level. The experience of our specialists, ongoing improvements abroad, and close collaboration with leading European clinics enable us to perform kidney resection with high skill and rid the patient of the threatening disease - kidney cancer.

Finally, we never leave our patients without further observation – we have a system in place for dynamic patient monitoring and rehabilitation.

author
Dr. Oganes E. Dilanyan
Urology-oncology surgeon, Ph.D. of Medical Sciences
Online Consultation
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