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Extended and organ preserving operations for kidney carcinoma

, : Extended and organ preserving operations for kidney carcinoma. Urologiya i Nefrologiya (3): 30-34

Operations were conducted on 162 patients with malignant growths of the kidney during the last 7 yr. The peculiar features of the diagnosis, therapeutic tacts, operative techniques and the results of treatment were analyzed in 2 groups of patients: those with extension of the blastomatous process to tissues and organs accessible for vision within the limits of the operative wound, when an extended operation is indicated, and those with malignant new growth of the kidney when nephrectomy is contraindicated. Extended operations (32) and organ-preserving operations (14) were carried out. After extended operations (those combined with lymphadenectomy, thrombectomy from vena cava inferior, hemicolectomy, etc.), almost 1/3 (10) of the patients have a survival period of > 3 yr. After organ-preserving operations (resection of the kidney and enucleation of the tumoral nodes), 10 patients have no metastases, 6 of whom have a survial period of > 3 yr. Organ-preserving operations seem possible in patients in whom nephrectomy is contraindicated (in cases with an anatomical or functional solitary kidney or bilateral affection of the kidneys) and are also justified in an intact contralateral kidney if the tumor is localized in one of the segments, does not grow into the capsule, the renal hilus is not involved in the process (insstage T1M0N0 of the process) and the vascular architectonics allows such an operation.

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