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Aktuelle Urol 2000; 31(4): 200-207
DOI: 10.1055/s-2000-4656
ÜBERSICHT
Georg Thieme Verlag Stuttgart · New York

Die Nierenteilresektion beim Nierenzellkarzinom: Prinzipien und Kontroversen

Partial Nephrectomy of Renal Cell Carcinoma: Principles and ControversiesA. van Ophoven2 , T. Senge1
  • 1Urologische Universitätsklinik der Ruhr-Universität Bochum, Marienhospital Herne, Herne
  • 2Klinik und Poliklinik für Urologie, Westfälische Wilhelms Universität zu Münster
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Publication History

Publication Date:
31 December 2000 (online)

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Zusammenfassung

Die Teilresektion von Nierengewebe ist stets dann von Interesse, wenn der Erhalt und die Schonung renalen Parenchyms notwendig werden. Die erstmalige Partialresektion einer Niere wurde im Jahre 1884 von Wells durchgeführt, die erste Teilresektion aufgrund eines malignen Nierentumors wurde 1890 von Czerny beschrieben. In der Folge hat sich die Nierenteilresektion zu einer chirurgischen Standardmethode in der Behandlung des Nierenzellkarzinoms entwickelt und als effektive und zuverlässige Methode erwiesen. Ihre Bedeutung als therapeutische Option in der Kontrolle lokaler Nierentumoren ist vom richtigen Einsatz diagnostischer Methoden abhängig, da hierüber die korrekte Indikationsstellung und Patientenselektion erfolgt. Darüber hinaus müssen operative Kenntnisse und Fähigkeiten der chirurgischen Komplexität des Eingriffes gerecht werden, um postoperative Komplikationen zu vermeiden und das Auftreten von Tumorrezidiven zu kontrollieren. Die folgende Übersichtsarbeit führt die kontroversen Diskussionen und umfangreichen Studienergebnisse, sowie die grundlegenden Sachthemen zur Nierenteilresektion auf, durch die der aktuelle Stellenwert dieser operativen Methode gekennzeichnet ist.

Abstract

Whenever preservation of functioning renal parenchyma is important nephron-sparing surgery should be substituted for radical nephrectomy. The first partial nephrectomy was performed in 1884 by Wells for the removal of a perirenal fibrolipoma. Partial nephrectomy because of renal malignancy was first described in 1890 by Czerny. Today partial nephrectomy has become a standard procedure and provides effective therapy for appropriately selected patients with renal cell carcinoma. However, its future importance and value as a therapeutic option for the control of localized kidney tumor depends on the use of the correct diagnostic inventory to obtain an accurate indication and proper patient selection. Moreover, explicit attention has to be drawn to the surgical skills required to perform this complex operation and to prevent postoperative complications and control tumor recurrence.

Key words

Nephrectomy - Carcinoma - renal cell - kidney neoplasms - Follow-up studies - Surgery

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Dr A van Ophoven

Klinik und Poliklinik für Urologie, Westfälische Wilhelms Universität zu Münster

Albert Schweitzer-Str. 33 48129 Münster

Phone: Tel. 0251-834-8001

Fax: Fax 0251-834-8492

Email: E-mail: ophoven@usa.net

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