Principles of surgical treatment of renal cancer

Renal cancer is the most common renal solid tumor. Currently, the most basic treatment method is still surgery. The specific surgery should be determined based on the patient's physical condition and the growth of the tumor.

1. Any patient with renal cancer who has been diagnosed should undergo radical nephrectomy at an early stage. In addition to radical nephrectomy, all ureters and the bladder wall around the ureteral orifice should be removed for renal pelvic cancer. If the tumor thrombus in the renal vein has extended to the vena cava, it should be removed and then the vena cava should be repaired.

2. For patients with localized bilateral renal cancer or solitary renal cancer, partial nephrectomy can be performed using ex vivo renal technology. When the tumor is extensive and the adjacent organs are involved and cannot be removed, palliative renal artery embolization can be performed, supplemented by radiotherapy and chemotherapy.

3. If the nephroblastoma is too large, radiotherapy can be performed before surgery, and radical nephrectomy can be performed after the tumor is reduced.

4. During resection, embolization of the affected renal artery can be performed simultaneously with selective renal artery angiography to help reduce intraoperative bleeding and tumor cell metastasis. Nephrectomy can be considered for patients with renal hamartomas that are large, have damaged renal structures, and have lost function.

5. After surgery, patients should have regular follow-up visits and undergo chest X-rays, B-ultrasound, and whole-body bone scans to help detect renal pedicle recurrence and metastasis in a timely manner.

Tips: Ex vivo kidney surgery

Ex vivo renal surgery is a difficult and complicated operation. According to the autologous kidney transplantation method, the affected kidney is removed for cooling and irrigating, the diseased part of the renal tissue is removed and the kidney is repaired. Finally, the kidney is transplanted to the ipsilateral iliac fossa and various drainage tubes are placed.