Kidney Cancer Treatment
Currently, Radical Nephrectomy is considered the “Gold Standard” for removal of kidney tumors. This traditionally has been performed through a large open incision. In most situations, our experienced surgeons can perform this surgery laparoscopically. For smaller tumors, often a robotic partial nephrectomy or laparoscopic renal cryoablation can be performed. This affords excellent cancer control while sparing the normal functioning portion of the kidney. Emerging literature is now favoring partial nephrectomy or renal cryoablation for smaller lesions. The potential benefits of laparoscopic/robotic surgery are numerous and include shorter hospital stays, less risk of infection, less pain and scarring, less blood loss and faster recovery than traditional open surgery.
KIDNEY CANCER TREATMENT OPTIONS
Radical Nephrectomy is the complete removal of the entire diseased kidney. This also includes the fat and sometimes can include the adrenal gland. This method is currently the gold standard for removal of kidney tumors. This procedure can be performed through an open incision or laparoscopically.
The majority of renal tumors can be removed laparoscopically, using small incisions to remove the kidney intact. The long-term cancer control results are also no different between the open and laparoscopic or robotic procedures.
Benefits of Laparoscopic Radical Nephrectomy versus Open Nephrectomy
- Smaller incisions (3-5 one inch incisions)
- Bikini line incision to remove kidney
- Less blood loss with rare need for blood transfusion
- Less pain
- Less narcotic usage
- Earlier discharge home (typical 24-48 hour stay for patient)
- Earlier ambulation
- Faster recovery
- Flank Incision (often 12 inches or greater – Lower Side/ Back)
- Extremely painful surgery
- Lengthy Hospitalization 5-7 days
- Higher volume of blood loss
- Higher narcotic requirement
Complete Kidney Removal
Although complete kidney removal has widely been accepted as standard of care, emerging data suggests preserving normal renal tissue is paramount in prevention of renal insufficiency and renal failure.
This is especially important in patients with other medical co-morbidities, such as hypertension, diabetes and vascular disease.
Therefore, the physicians at McIver Clinic have placed a strong emphasis on renal preservation in treatment of kidney cancer.
Our goal is to offer complete cancer control while using state-of-the-art minimally invasive techniques.
Partial Nephrectomy is a renal sparing procedure that removes the kidney tumor while leaving the non-cancerous, normal functioning part of the kidney in tact. Research has shown that in appropriately selected patients the results of Partial and Radical Nephrectomy are similar in terms of long-term survival. Partial Nephrectomy is becoming the standard of care for many patients with renal masses less the 4 cm. in size. Partial Nephrectomy can be performed both with open, robotic or laparoscopic surgery.
Robotic Partial Nephrectomy is an excellent option for appropriately selected patients. This minimally invasive procedure removes the renal tumor through small incisions while preserving the remaining normal kidney. In addition to the short-term benefits patients gain from robotic surgery, research has shown equivalent cancer control. Emerging data has demonstrated a decreased risk of chronic kidney disease (CKD), and lower rates of dialysis for patients undergoing Partial Nephrectomy.
Open Partial Nephrectomy involves an open flank or abdominal incision to localize the kidney. The tumor is located and removed while the rest of the kidney is left intact. The long-term results for cancer control have been favorable. Unfortunately, this requires a large, painful incision to safely perform this procedure.
Laparoscopic/Robotic Renal Cryoablation
Renal Cryoablation is another form of therapy that emphasizes renal preservation.
Renal Cryoablation involves destruction of the kidney tumor using minimally invasive techniques while sparring the normal tissue of the kidney. Termed “thermo-therapy”, the procedure uses freezing temperatures less than -40 Celsius to treat the lesion. The tumor is destroyed while leaving the surrounding tissue intact and functioning.
The technology is relatively new and is currently only performed by select surgeons who have received special training. Short-term results have been promising, and the American Urological Association recently included this treatment as an option for tumors less than 4 c. in size. This technology has provided a new surgical treatment option to patients. This is also an excellent option for patients who have multiple medical problems or are not deemed fit for more aggressive surgical intervention.