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2015 ; 2
(2
): 64-69
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Tumor Enucleation for Renal Cell Carcinoma
#MMPMID28326260
Smith ZL
; Malkowicz SB
J Kidney Cancer VHL
2015[]; 2
(2
): 64-69
PMID28326260
show ga
The increased number of small renal masses (SRMs) detected annually has led to a
rise in the use of nephron-sparing surgery (NSS). These techniques aim to
preserve the largest amount of healthy renal tissue possible while maintaining
the same oncologic outcomes as radical nephrectomy (RN). Additionally, partial
nephrectomy (PN) has been linked to a lower risk of chronic kidney disease,
cardiovascular morbidity, and mortality when compared to RN. There has been
continual progress toward resecting less renal parenchyma. While the predominant
surgical method of performing NSS is through traditional PN, simple enucleation
(SE) of the tumor has increased in popularity over recent years. SE is a
technique that aims to preserve the maximal amount of renal parenchyma possible
by utilizing the renal tumor pseudocapsule to bluntly separate the lesion from
its underlying parenchyma, offering the smallest possible margin of excised
healthy renal tissue. Several studies have demonstrated the oncological safety of
SE compared with PN in the treatment of SRMs, with lower overall incidence of
positive surgical margins. Additionally, SE has been shown to have similar 5- and
10-year progression-free and cancer-specific survival as PN. We present a review
of the literature and an argument for SE to be a routine consideration in the
treatment of all renal tumors amenable to NSS.