الفهرس 
SummaryOnly 14 pages are availabe for public view
 |  | from | 161 |  |  |
| | | from | 161 | | |
Abstract
SUMMARY AND CONCLUSION
Nephron sparing nephrectomy is a new line for treating renal cell
carcinoma and compared with the most approved radical nephrectomy
need to be done in a perfect manner, for that, a good knowledge of the
arrangement of the renal vascular tree in relation to the pelvis and
calyces. The segmental blood supply and the time not to exceed when
occlude renal artery to prevent permanent ischaemic damage to kidney is
the first step 111 planning and perfroming a safe uncomplicating surgical
procedure.
The diagnosis of renal cell carcinoma depends on clinical picture,
instrumental investigation and differential diagnosis with other diseases
sharing symptoms and signs.
Renal cell carcinoma with its different pathological types, size and
position in the kidney is treated by total or radical nephrectomy the
manner that not become suitable for urologists whose primary purpose
was preservation of renal function although the quality of life is
maintained by the other functioning kidney but some times in conditions
where caneer occur in that kidney or certain pathology and trauma that
disturb the function of that kidney the condition necessitate preservation
surgery for the renal cell carcinoma to overried the risks of renal dialysis
and kidney transplantation. Eftbrts were directed to type of surgical
maneuver that preserve the healthy functioning kidney tissue and
complete removal of the cancer J,y making use of the scientific advances
in early detection and precisely ~rmining the site and size of the cancer ,
in recent years. Nephron sparill surgery has been established as an
effective method of treatme’” for patients with localized renal cell
l
carcinoma in whom preserva~ of functioning renal parenchyma is
!
relevant clinical condition. The technique success rate of nephron- spamg
surgery is high, and long-term cancer free survival is comparable to that
obtained after radial nephrectomy particularly for low stage carcinoma.
The evolving minimally invasive sparing surgery such as
laparoscopic partial nephrectomy, cyrotherapy, radio frequency ablation
and high intensity focused ultra-sound has the advantages of being
nephreon sparing, short hospital stay and early recovery. It needs well
experienced surgeon and lack of proper detection of complete removal of
the tumour also it is limited to small tumour size less than 3cm.
According to different studies made to compare the outcome of
radical versus consevative surgery the cancer-specific five year survival
rate was about 94% for the former and 96% for the latter. These results
suggest that NSS can be performed safely and with minimal associated
morbidity. Of course, it is assumed that the surgeon has adequate
experiences with nephron sparing surgery. Hilar and centrally located
tumors clearly present a greater technical cahllenge and should only be
attempted by those with experience with these techniques.