There has been a constant increase in the incidence of renal cell cancer in the last few decades but at the same time, there has been a uniform decrease in the normal size of tumors when observed closely. This event can be credited to increased incidental detection of renal tumors by noninvasive imaging modalities. There has also been a drift towards using nephron-sparing surgery, and minimally invasive strategies in the management of these tumors. In this blog we will discuss about the growing acceptance of this partial procedure.
What Is Partial Nephrectomy?
Partial nephrectomy is also introduced as nephron-sparing surgery or kidney-sparing surgery wherein the surgeon segregates the tumor and saves the kidney. This is an elegant method that insists for an accomplished surgeon and surgical team.
Why Partial Nephrectomy?
If you are not aware let me make you aware that this procedure is more valuable than a total removal as, during this procedure only the cancerous tumor or infected tissue is separated, leaving in place as much healthy kidney tissue as feasible. Investigations have revealed that a partial nephrectomy can eliminate the tumor and achieve results similar to total kidney removal. This has been well authorized for tumors less than four cm and there is rising research suggesting that the same is true for bigger tumors.
The present trend suggests approximately 75-80% of all kidney tumor cases <7cm in size without a sign of vein or fat involvement are successfully treated with robotic partial nephrectomy. Patients who have very large tumors or deep tumors next to the blood supply of the kidney may be better suited to undergo a radical nephrectomy.
With the aid of Computerized axial tomography (CAT) which uses x rays and magnetic resonance imaging (MRI) scan, it is easier to assess the feasibility and safety of this disease.
Who Is The Right candidate For Partial Nephrectomy?
Generally,this procedure is most relevant for kidney tumors <4cm in size and one which is located on the periphery of the kidney. In instances when patients have a solitary functioning kidney, two-sided kidney tumors, or when a radical nephrectomy would leave the patient without functioning kidneys, surgeons may be extra proactive in initiating a partial nephrectomy approach to avoid the need for hemodialysis.
A right candidate could also be a patient who has risk factors for kidney failure. The most widespread reasons patients have poor kidney function now are diabetes and high blood pressure. Having these circumstances means that you may already have more critical kidney function than you believe. Protecting the kidney will sustain a better kidney function and prevent kidney failure in the future.
In certain cases, the patient has kidney stones and have only one kidney and a stone chooses to pass and block the ureter it then converts into a medical emergency. The blockage not only harms the remaining kidney and but blocks the urine from going into the bladder.
What Are The Consequences of the procedure ?
Cure post-treatment of renal cell carcinoma depends on many factors including the tumor size and stage, nodal involvement, tumor grade, cell type, and margin status. It has been estimated that disease control rates for robotic partial nephrectomy are different and exceed 90-95% in patients with stage T1 lesions (<7cm). There have been various historical studies that have not presented any cancer control discrepancies between patients who have undergone a partial nephrectomy vs radical nephrectomy.
Besides, tumors that arise from the kidney collecting system (lining of the kidney drainage sac) are also managed with complete kidney removal and are not agreeable to this procedure.
Post-surgery, you will be observed with repeated chest X-rays and CT scans of the chest, abdomen, and pelvis to estimate for any recurrence of cancer. These will be conducted at appropriate intervals based on your risk of recurrence.
There are two types of nephrectomy for a diseased kidney: partial and radical but which treatment could be best for you could be decided by Dr Ashish Saini a renowned kidney doctor and an expert when it comes to any types of Kidney cancer treatment in Delhi.