The main organ of the urinary system is the kidney, one at each side, bilaterally of the spinal cord, under the diaphragm and in close anatomic relation with other organs of the abdomen, such as liver, pancreas, duodenum, large abdominal vessels, adrenal glands and large intestine. This complexity of the surrounding structures is what makes the performance of that kind of procedures an object for specialised surgical oncology teams, familiar with the anatomy of both the abdominal and retroperitoneal space.
Kidneys are involved in numerous important functions: they filter blood and get rid of toxic substances through urine, they fix the balance of fluids and electrolytes, they produce hormones that control blood pressure, red blood cells production and calcium metabolism.
Kidney or Renal cancer is the third more frequent malignancy of the urine system and it its frequency is steadily escalated worldwide the last years. Diagnosis, for more than 50% is done during random imaging (CT scans, ultrasound), taking into consideration that the disease does not include early symptoms.
Smoking, obesity, exposure to amianthus and cadmium, elevated blood pressure and male sex are considered risk factors.
The majority of renal tumors do not give symptoms until they reach to an advanced stage. The classic clinical triad (lumbar pain, bloody urine and palpable abdominal mass) has a delayed appearance, and is seen in less than 10% of the patients.
Treatment depends on the size of the tumor, the clinical stage of the disease, the patient’s age and general status. Treatment options available today are:
- Molecular targeted therapy
- Immunotherapy, chemotherapy and radiation
- Surgical therapy
From all of the above options, most important is the surgical treatment which is the cornerstone of the treatment of renal cancer. Partial nephrectomy is applied in small tumors, on the other hand radical nephrectomy is indicated for larger tumors. These procedures are performed by means of robotic and laparoscopic surgery.