Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Q Building - Glickman Tower, 2050 East 96th Street, Cleveland, OH 44195, USA.
Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Q Building - Glickman Tower, 2050 East 96th Street, Cleveland, OH 44195, USA.
Urol Clin North Am. 2023 May;50(2):239-259. doi: 10.1016/j.ucl.2023.01.004. Epub 2023 Feb 20.
Knowledge of functional recovery after partial (PN) and radical nephrectomy for renal cancer has advanced considerably, with PN now established as the reference standard for most localized renal masses. However, it is still unclear whether PN provides an overall survival benefit in patients with a normal contralateral kidney. While early studies seemingly demonstrated the importance of minimizing warm-ischemia time during PN, multiple new investigations over the last 10 years have proven that parenchymal mass lost is the most important predictor of new baseline renal function. Minimizing loss of parenchymal mass during resection and reconstruction is the most important controllable aspect of long-term post-operative renal function preservation.
在部分(PN)和根治性肾切除术治疗肾癌后的功能恢复方面,人们的认识已经有了很大的提高,PN 现在已经成为大多数局限性肾肿瘤的参考标准。然而,PN 是否能为对侧肾脏正常的患者提供整体生存获益仍不清楚。虽然早期研究似乎表明在 PN 过程中尽量减少热缺血时间的重要性,但过去 10 年来的多项新研究证明,实质质量损失是新的基础肾功能的最重要预测因素。在切除和重建过程中尽量减少实质质量的损失是长期术后肾功能保存的最重要的可控方面。