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Oncological Urology

 Kidney Cancer Surgical Treatments 

When the cancer is confined in the kidney (not spread to the other organs) surgery is a primary treatment method used. No further medicaments or radiation will be used. Patients after the surgery are routinely monitored. The first year it will be every 3 month and every 6 month for the following 2 years. After that period – once a year check up is recommended. Both types of surgery mentioned below are performed by dr Corona utilizing minimally invasive approach to minimize pain and blood loss, shorten the hospital stay and recovery time, significantly minimize the scar size 

 

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Nephron - sparing surgery (Partial Nephrectomy - PN)

 

Surgery that preserves part of the kidney, preserving that way also its function. Partial Nephrectomy is more demanding surgery and requires more surgical skills, experience from the surgeon due to higher risk of the blood loss and other complications. For this surgery type dr Corona recommends the robot – assisted approach, due to better precision and less risk of positive surgical margins even if can be perform with pure laparoscopic technique

considerable for the patients with:

  • younger patients

  • no significant comorbidities (other diseases) 

  • clinically localized cancer (not spread out of the kidney)

  • pre-existing chronic kidney disease – to avoid further deterioration of kidney function and higher risk of development ESRD and need for hemodialisis

  • T1 RCC

disadvantages of PN

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  • more complicated surgery, requires higher experience and skills from surgeon

  • higher risk of complications

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advantages of PN 

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  • kidney function preserved

Radical Nephrectomy - RN

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Surgery that removes one of the kidneys. This surgery dr Corona performs mostly utilizing laparoscopic approach, due to the small amount of space in a surgical field. This surgery requires additional scar for the kidney to be removed at the end of the surgery. This scar is done at the lover abdomen on the side of the removed kidney. Comparing to the open surgery it is still small – 7-10 cm comparing to 30-40 cm in open approach

considerable for the patients with:

  • insufficient volume of remaining parenchyma to maintain a proper organ function

  • renal vein thrombosis

  • T2 RCC

  • localized tumor mass, not treatable by Partial Nephrectomy

disadvantages of RN

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  • loss of one kidney

advantages of RN

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  • performed when there is no possibility to spare the kidney

  • lover risk of compared to PN

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