Withington John, Neves Joana B, Barod Ravi
Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
Curr Urol Rep. 2017 Aug;18(8):61. doi: 10.1007/s11934-017-0705-8.
This article aims to summarise recent developments in surgical and minimally invasive therapies in the management of small renal masses (SRMs).
The incidence of the small renal mass is increasing. Standard management of the SRM is partial nephrectomy. More recently, use of ablative techniques to manage the SRM has been increasing and an exciting array of technical advances is currently being made in the field. Nephron-sparing surgery looks set to become more financially viable with the advent of newer robotic platforms and, potentially, even less invasive with the evaluation of single-port access. Real-time imaging promises to improve tumour definition, nephron preservation and vascular management intraoperatively. Advances in surgical and minimally invasive therapies for the management of the SRM have the potential to improve cancer clearance and long-term renal function preservation. Patients will experience safer, more reliable and less invasive treatments for their small renal tumours. We describe the current advances underlying these changes.
本文旨在总结小肾肿瘤(SRMs)外科及微创治疗的最新进展。
小肾肿瘤的发病率正在上升。SRM的标准治疗方法是部分肾切除术。最近,采用消融技术治疗SRM的情况不断增加,该领域目前正在取得一系列令人振奋的技术进步。随着更新的机器人平台的出现,保留肾单位手术在经济上似乎更具可行性,而且随着单孔入路评估的开展,其侵入性甚至可能更低。实时成像有望在术中改善肿瘤界定、肾单位保留及血管管理。SRM外科及微创治疗的进展有可能提高癌症清除率并保留长期肾功能。患者的小肾肿瘤将接受更安全、更可靠且侵入性更小的治疗。我们描述了这些变化背后的当前进展。