[Adrenalectomy within the scope of tumor nephrectomy?].
In urology, renal cell carcinoma is the third most frequently diagnosed malignancy. Localized, non-metastatic tumors are generally cured by radical tumor nephrectomy. Since the 1960s, this procedure has routinely included removal of the kidney together with the perirenal fat, Gerota's fascia, and ipsilateral adrenal gland. In recent years, improved diagnostic methods have led to the detection of tumors at earlier stages. These methods widen the scope for organ-sparing surgical strategies and have consequently sparked controversy over adrenal gland removal. Despite this, radical tumor nephrectomy that includes adrenal gland removal is still strongly advocated. This is the only suitable surgical approach for the cure of patients with direct tumor infiltration of the adrenal gland. In the case of adrenal involvement, minimal tumor dimension and the predisposing localization of the primary tumor have to relevance. The imaging procedure for diagnosis is also difficult to assess, especially in slim patients with upper role tumors. Finally, to date, no justifiable disadvantages of adrenalectomy have been described.
Urologische Klinik, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1, 68135 Mannheim.
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Hoang-Böhm
F J
FJ
Martinez Portillo
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Roth
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Alken
D000311:Adrenal Glands / Q000473:pathology; D000315:Adrenalectomy; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D003952:Diagnostic Imaging; D006801:Humans; D007668:Kidney / Q000473:pathology; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009392:Nephrectomy; D019564:Unnecessary Procedures