Challenging situations in partial nephrectomy.
Although most partial nephrectomies are performed as primary procedures in the elective or semi-imperative setting on kidneys with relatively normal anatomy, this is not always the case. The indications for partial nephrectomy continue to expand and it is becoming particularly relevant in patients with single functioning kidneys, poor kidney function, anatomical anomalies and hereditary syndromes predisposing to multiple kidney cancers, such as Von Hippel-Lindau syndrome. These, along with previous abdominal surgery, pose surgical challenges. In this article we offer advice as to how to tackle these unusual situations. An ability to master the whole range of indications will allow the modern upper renal tract surgeon to offer partial nephrectomy to a wider range of patients.
MRC Centre for Transplantation, Faculty of Life Sciences & Medicine, King's College London, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom. Electronic address: nicholasraison@gmail.com.
Nicholas
N
Raison
Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom.
Norbert
N
Doeuk
Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom.
Theo
T
Malthouse
University College London Hospital, 235 Euston Rd, Fitzrovia, London NW1 2BU, United Kingdom.
Veeru
V
Kasivisvanathan
Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom.
Wayne
W
Lam
Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom.
Ben
B
Challacombe
D000005:Abdomen / Q000601:surgery; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery; D007680:Kidney Neoplasms / Q000601:surgery*; D009392:Nephrectomy / Q000379:methods*; D013577:Syndrome; D006623:von Hippel-Lindau Disease / Q000601:surgery*
Horseshoe Kidney; Partial Nephrectomy; Pelvic Kidney; Single Kidney; Von Hippel-Lindau Disease