O'Brien W M, Lynch J H
Urology. 1987 Jun;29(6):605-7. doi: 10.1016/0090-4295(87)90100-2.
Recently, there have been questions raised as to the results and feasibility of performing renal-sparing procedures for localized renal cell carcinoma. We reviewed the records of 72 patients treated with standard radical nephrectomy to determine the incidence of adrenal involvement and to determine if adrenal lesions were detectable by radiographic methods preoperatively. Four patients had evidence of adrenal involvement for an overall incidence of 5.5 per cent. All had upper pole lesions. Adrenal involvement in each case was apparent at surgery or on preoperative imaging studies. For patients with middle and lower pole localized renal cell carcinoma who have normal findings on preoperative computerized tomography scans, modified radical nephrectomy sparing the adrenal gland may be a surgical alternative to radical nephrectomy.
最近，对于局限性肾细胞癌实施保留肾单位手术的结果及可行性引发了一些问题。我们回顾了72例行标准根治性肾切除术患者的记录，以确定肾上腺受累的发生率，并确定术前影像学方法能否检测到肾上腺病变。4例患者有肾上腺受累证据，总体发生率为5.5%。所有患者均为上极病变。每例患者的肾上腺受累在手术时或术前影像学检查中均很明显。对于术前计算机断层扫描结果正常的中、下极局限性肾细胞癌患者，保留肾上腺的改良根治性肾切除术可能是根治性肾切除术的一种手术替代方案。
