Intraoperative ultrasound during renal parenchymal sparing surgery for hereditary renal cancers: A 10-year experience

P. L. Choyke, C. P. Pavlovich, K. D. Daryanani, S. M. Hewitt, W. M. Linehan, M. M. Walther

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We review our 10-year experience with intraoperative ultrasound during renal parenchymal sparing surgery in patients with hereditary renal cancers. Materials and Methods: Between 1991 and 2000, 68 nephron sparing procedures were performed on 26 women and 27 men, all but 1 of whom had a hereditary predisposition to renal cancer, for example von Hippel-Lindau, hereditary papillary renal cancer. Intraoperative ultrasound was performed after the surgeon removed all visible or palpable lesions. High frequency transducers (7 MHz.) and color Doppler were used in all cases. Lesions were characterized as simple cysts, complex cysts or solid masses, and were recorded on a map. Results: A total of 935 lesions (mean 12.8 lesions per kidney) were removed in 68 nephron sparing operations performed on 53 patients. Of these lesions 870 were removed without while 65 required intraoperative ultrasound. In 17 of 68 (25%) procedures intraoperative ultrasound identified renal cancers that were not detectable by the surgeon. Mean tumor size of ultrasound detected lesions was 1.0 cm. (range 2 mm. to 4 cm.). Of the 32 cystic lesions identified by intraoperative ultrasound 5 contained renal carcinoma, and 29 of the 33 solid renal masses were renal cell carcinomas. During reoperations ultrasound enabled the surface of the kidney to be evaluated even when it was inaccessible due to scar tissue or adherent perinephric fat. Conclusions: Intraoperative ultrasound can be performed after all visible lesions have been removed and identifies additional tumors in 25% of patients with hereditary renal cancer, thus ensuring that as many tumors as possible have been removed during renal parenchymal sparing surgery.

Original languageEnglish (US)
Pages (from-to)397-400
Number of pages4
JournalJournal of Urology
Volume165
Issue number2
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

Keywords

  • Intraoperative care
  • Kidney neoplasms
  • Neoplastic syndromes, hereditary
  • Ultrasonography

ASJC Scopus subject areas

  • Urology

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