Sonographic staging after nephrectomy for tumours.

Sonography for postoperative staging after malignant renal tumours was evaluated in this study based on multiple examinations in 63 patients. Sonography permits a critical examination of the liver, the abdomen in general, the retroperitoneal space, including the renal fossa and solitary kidney. Local recurrences after hypernephroma operation were found in 5.3% and after nephrectomy for renal pelvic carcinoma in 68%. Retroperitoneal lymph node metastases appeared in 17% of the patients operated on renal pelvic carcinoma and in 7.6% after hypernephroma operation. These data indicate that special attention should be drawn to the renal fossa after tumour nephrectomy. The higher incidence of recurrences in the renal fossa, and metastatic lymph node involvement in patients following nephrectomy for renal pelvic carcinoma compared with the situation after hypernephroma operation might be explained by the difference of the lymph drainage between the renal pelvis and renal parenchyma which, in addition, includes a separate ontogenetic development. The majority of secondary lesions in hypernephroma patients occur as lung and bone metastases which have been discovered by conventional X-ray examination. These data are not statistically evaluated in the study.