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Biotechnology That is Used to Cure Kidney Cancer

 

 

Open Partial Nephrectomy

Questions for Dr. Landman
 

Definition:
Open partial nephrectomy is defined as a removal of a portion of the kidney to achieve total removal of the entire tumor.

Technique:
Open partial nephrectomy is performed through a single 6- to 7 Inch abdominal or flank incision. As the incision is large enough to work through, the procedure is done without the use of a laparoscopic cameras' or gas to expand the body spaces. Open partial nephrectomy is the kidney sparing surgery with the longest tract record and is often considered the gold standard for nephron sparing surgery. All of the new surgeries that have been introduced into clinical practice are compared to open partial nephrectomy for control of kidney cancer and for recovery from the operation.

Candidates:
Open partial nephrectomy is ideally suited for the patient with larger renal tumors that invade deeply into the renal tissue. Having an open partial nephrectomy is often called for when these larger and deeper kidney cancers exist in patients whose total kidney function is limited or if the cancer exists in a patient with only one kidney. Open partial nephrectomy is also ideally suited for patients who are generally healthy and can tolerate general anesthesia.

Advantages / Disadvantages:
The advantages of open partial nephrectomy include the ability to put sterile ice on the kidney to cool the kidney to very low temperatures during the operation. Cooling the kidney prevents damage to the kidney during the surgery, and kidney cooling can only be efficiently done with open partial nephrectomy. In addition, open partial nephrectomy is associated with a low rate of urinary leakage, positive surgical margins (leaving cancer on the remaining kidney), and blood transfusion.

The disadvantages of open partial nephrectomy when compared to minimally invasive techniques are generally the differences in short-term morbidity such as length of hospital stay, the need for pain medication to control pain after the procedure, and time to return to full activity.

The Procedure:
Open partial nephrectomy is performed via a subcostal or flank incision under general anesthesia. The operative time is usually 3 to 3 1/2 hours, and an ultrasound device is utilized during the operation to allow the surgeon to identify the tumor and precisely remove it while sparing as much of the normal kidney as possible. During the operation the kidney is temporarily cooled with ice to protect against potential damage caused by lack of blood flow within the kidney.

Follow-up:
Following an open partial nephrectomy operation, the final pathology report is reviewed with the patient approximately one week after the surgery, and appropriated imaging studies are arranged on an interval basis to monitor both kidneys.

 

 
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Laparoscopic Partial Nephrectomy

Laparoscopic Radical         Nephrectomy

Robotic Partial Nephrectomy

Complementary Mangement Strategies

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