Blitstein Jeffrey, Ghavamian Reza
Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
Expert Rev Anticancer Ther. 2008 Jun;8(6):921-7. doi: 10.1586/14737140.8.6.921.
With the advent of cross-sectional imaging, the incidence of asymptomatic detected small renal masses, 'incidentalomas', has increased in the past 20 years. Recent studies have demonstrated that patients with renal masses have worse renal function at baseline and have more comorbidities than the general population. Nephron-sparing surgery allows for maximal preservation of functioning nephrons with comparable oncologic outcomes. Recently, laparoscopic partial nephrectomy has emerged as a minimally invasive nephron-sparing surgical option for treating the appropriately selected renal mass. While open-partial nephrectomy has undisputedly become standard of care for the management of the small renal mass (<4 cm), laparoscopic partial nephrectomy is becoming the preferred option for select patients in institutions in which advanced laparoscopic experience is available.
随着横断面成像技术的出现，在过去20年里，无症状性小肾肿块（“偶发瘤”）的检出率有所上升。最近的研究表明，肾肿块患者在基线时肾功能较差，且合并症比普通人群更多。保留肾单位手术能够在保证肿瘤学疗效相当的情况下，最大程度地保留有功能的肾单位。近年来，腹腔镜下肾部分切除术已成为治疗经适当选择的肾肿块的一种微创保留肾单位手术方式。虽然开放性肾部分切除术无疑已成为治疗小肾肿块（<4 cm）的标准术式，但在具备先进腹腔镜手术经验的机构中，腹腔镜下肾部分切除术正成为部分患者的首选术式。
