Lokalize Böbrek Tümörlerinde Nefron Koruyucu Cerrahi

Öz

Günümüzde görüntüleme yöntemlerinin artması ve rutin olarak kullanılması nedeniyle insidental olarak tespit edilen asemptomatik, küçük hacimli lokalize böbrek tümörlerinin sayısında belirgin artış saptanmıştır. Tümörün böbreğe sınırlı kaldığı ve vücuda yayılmadığı kitleler lokalize böbrek kanseri olarak tanımlanmaktadır. Uzun yıllar açık radikal nefrektomi lokalize böbrek tümörlerinin tedavisinde altın standart yöntem olarak kabul edilip uygulanmakla birlikte son 3 dekkaddır organ koruyucu yaklaşım popülarite kazanmıştır. Lokalize böbrek kanserinin yönetiminde laparoskopi ve minimal invaziv tekniklerin getirilmesi ile karşılaştırılabilir onkolojik sonuçlar elde edildi ve morbiditenin azaltılmasına sebep olundu. Lokalize böbrek kanserli hasta için tedavi seçiminin bireyselleştirilmesi gerekir ve onkolojik sonucu etkilemeden böbrek fonksiyonunun korunması karar verme sürecinde en önemli amaç olmalıdır. Hastanın performans durumu ve cerrahi uzmanlığı, hastaya en uygun tedavi seçeneği hakkında tavsiyede bulunurken önemli faktörler olacaktır. 

 

Biz bu derlemede lokalize böbrek tümörlerinde nefron koruyucu cerrahinin (NKC) ameliyat yöntemlerini endikasyonları, avantajları ve dezavantajlarını ele aldık.

Anahtar Kelimeler

• Böbrek,Nefron Koruyucu Cerrahi,Böbrek tümörü,Parsiyel Nefrektomi

Nephron-sparing Surgery in Localized Kidney Tumors

Abstract

As a result of the increasing and routine use of imaging methods, there is a significant increase in the number of asymptomatic small volume localized kidney tumors incidentally detected. The masses which is limited to the kidney and not spread to the body are defined as localized kidney cancer. Although open radical nephrectomy has been accepted as the gold standard method for the treatment of localized renal tumors for many years, organ conservative approach has gained popularity in the last 3 decades. For the patient with localized kidney cancer, the choice of treatment needs to be individualized and the preservation of renal function without affecting the oncologic outcome should be the most important goal in the decision-making process. The patient's performance status and surgical expertise will be important factors in advising the patient about the most appropriate treatment option.

In this review, we discussed the indications, advantages and disadvantages of  nephron sparing surgery (NSS) in localized renal tumors.

Keywords

• Kidney,Nephron Sparing Surgery,Renal Tumor,Partial Nephrectomy

Kaynakça

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