Principles of Kidney Surgery

Question 1

Partial nephrectomy indications?

Answer 1

1. STAGE I-III TUMORS WHEN FEASIBLE
2. UNINEPHRIC STATE
3. RENAL INSUFFICIENCY
4. BILATERAL TUMORS
5. FAMILIAL TUMORS
6. PATIENTS AT RISK FOR DEVELOPING PROGRESSIVE CKD

Question 2

When is regional lymph node dissection required?

Answer 2

PREOP CT SHOWS LYMPHADENOPATHY INTRAOP SHOWS LYMPHADENOPATHY

Question 3

If adrenal gland is uninvolved, is it necessary to perform adrenalectomy?

Answer 3

NO

Question 4

Thermal ablation is an option for management of what stage lesions?

Answer 4

T1 LESIONS, <3CM

Question 5

Ideally, thermal ablation can be used in what size of masses?

Answer 5

<3CM

Question 6

What is the risk in using ablation in masses larger than the cut off size?

Answer 6

RECURRENCE

Question 7

Ideal size of lesions in doing active surveillance?

Answer 7

<2CM

Question 8

Is active surveillance recommended in 4cm or less T1a tumors with PREDOMINANTLY CYSTIC COMPONENTS?

Answer 8

YES

Question 9

What does active surveillance entail?

Answer 9

SERIAL ABDOMINAL IMAGING WITH TIMELY INTERVENTION SHOULD THE MASS DEMONSTRATE CHANGES (INCREASING TUMOR SIZE, GROWTH RATE, INFLITRATIVE PATTERN) PERIODIC METASTATIC SURVEY - BLOOD WORK, CHEST IMAGING

Question 10

TWO prerequisites before doing cytoreductive nephrectomy.

Answer 10

1. ECOG <2
2. NO BRAIN METS

Question 11

Type of surgery that you will offer patients with metastatic disease who present with hematuria or other symptoms related to the primary tumor.

Answer 11

PALLIATIVE NEPHRECTOMY

Question 12

RENAL Score Components

Answer 12