Treatment of Kidney Tumors in Austria
Univ.-Prof. Priv.-Doz. Dr. Mesut Remzi
Expertise and experience in the field of kidney preservation and partial kidney resection have brought patients from all over the world to Döbling Private Hospital in the past.
Prof. Remzi, who is particularly at risk of developing a kidney tumor?
Renal cell carcinoma affects men to a greater extent. Certain forms, such as angiomyolipoma (a benign kidney tumor), are also more common in women. Risk factors for renal cell carcinoma include genetic factors, high blood pressure, smoking and gender. It is most common in the 50 to 55 age group.
How is the kidney tumor diagnosed and are there preventive medical check-ups for early detection?
Today, in the majority of cases, kidney tumors are detected as an incidental finding during other examinations. The tumor is often discovered during an abdominal CT scan, which does not always allow for an exact diagnosis and therapy planning. It is then important to get an accurate diagnosis. It takes a lot of experience to assess the tumor correctly. Four-phase CT or MRI of the kidneys are used as examination methods for diagnosis. A general staging (examination of the lungs as well) is also important. A PET-CT has a low value in renal cell carcinoma and is rarely used.
There is no classic preventive or early detection, but regular urological check-ups including renal sonography are recommended.
How is the tumor treated?
The most important and decisive measure in the treatment of kidney cancer is surgery. The aim of the operation is to completely remove the tumor and thus cure the disease. Cure can be achieved by surgery as long as the tumor is locally limited to the kidney. In addition, minimally invasive techniques are advantageous because blood loss, hospital stays, wound healing disorders and pain are significantly lower. The goal is usually to save the kidney affected by the tumor. The experience of the urologist is crucial for this decision. Our experience in kidney surgery is more than 1000 surgical cases.
Why is kidney surgery such a complex field?
Operations on the kidneys require a lot of experience, since you have to operate “against the clock”, so to speak. Because the kidney is cut off from the blood supply, the surgeon only has a limited time window to remove the tumor and reconstruct everything. It takes a lot of practice to do this in the given time. There are also numerous surgical tricks to avoid or minimize the pinching phase of the kidney.
Radical nephrectomy used to be the gold standard in the treatment of all renal cell carcinomas. Today, the preservation of the kidney is a goal wherever possible. In which cases does this work?
In the vast majority of cases it is now possible to preserve kidneys, except in the case of very advanced stages. Whether it makes sense to preserve the kidney is discussed with the patient on a case-by-case basis and can be achieved in the majority of cases. A minimally invasive (laparoscopic) approach is usually also possible.
When can an operation be performed minimally invasive and what are the advantages over open surgery?
Whether a minimally invasive operation is possible depends primarily on the expertise of the surgeon. We can already operate on up to 90% of presented cases using minimally invasive methods. This applies both in the case of surgery with kidney preservation and in the case of kidney removal. The advantages are in the lower morbidity of the operation, less pain, less blood loss, faster convalescence, fewer wound healing disorders and faster hospital stays.
How long is the usual hospital stay after the operation and how long is the rehabilitation?
The hospital stay lasts 3-5 days. Patients usually recover relatively quickly and can soon go about their normal everyday activities. In general, however, physical rest is necessary, and you should not do any sport for 4 weeks, this applies above all to the kidney-sparing operation.
How does the therapy continue after the operation?
As a rule, the operation is curative, i.e. no further therapy is required. What is new for high-risk patients is the possibility of adjuvant (=supportive) immunotherapy, but this data is still under discussion due to more recent findings and must be discussed individually. As a rule, however, no further therapy such as chemotherapy is required.
What advantages does the Döbling Private Hospital offer for the diagnosis and treatment of kidney tumors?
In the Döbling Private Hospital, we have the most modern operating rooms available, which allow the use of innovative, gentle surgical methods. The therapeutic approach is always individually tailored to the patient, who is advised with great sensitivity and at eye level.
Due to the flexible organization, there are hardly any waiting times for either diagnostics or operations. Döbling Private Hospital has a large network of top specialists. Interdisciplinary treatment by experienced specialists is essential, especially in the treatment of oncological diseases. Patients receive continuous care from their treating physician, who acts as their point of contact throughout the treatment cycle.
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