Clinical Director, University of Texas Medical Branch School of Medicine
Bilateral hand-assisted laparoscopic nephrectomy for autosomal dominant polycystic kidney disease using a single midline HandPort incision asthmatic bronchitis airways advair diskus 500mcg otc. Laparoscopic cyst decortication in autosomal dominant polycystic kidney disease: impact on pain asthmatic bronchitis mucus purchase advair diskus on line, hypertension asthma while pregnant order advair diskus 250 mcg with amex, and renal function asthma treatment gnc buy generic advair diskus 500 mcg. Role and long-term results of laparoscopic decortication in solitary cystic and autosomal dominant polycystic kidney disease. Laparoscopic bilateral native nephrectomies with simultaneous kidney transplantation. Laparoscopic bilateral hand assisted nephrectomy for autosomal dominant polycystic kidney disease: initial experience. Contraindications to needle aspiration of a solid renal mass: tumor dissemination by renal needle aspiration. Robotic-assisted laparoscopic pyeloplasty and nephropexy for ureteropelvic junction obstruction and nephroptosis. Laparoscopic nephropexy using tension-free vaginal tape for symptomatic nephroptosis. Trends in renal surgery: robotic technology is associated with increased use of partial nephrectomy. Laparoendoscopic single-site surgery of the kidney with no accessory trocars: an initial experience. Laparoendoscopic single-site surgery versus standard laparoscopic simple nephrectomy: a prospective randomized study. Robotic partial nephrectomy versus laparoscopic partial nephrectomy for renal cell carcinoma: single-surgeon analysis of >100 consecutive procedures. Experience of 143 cases of laparoscopic surgery in urology-clinical outcome in comparison to open surgery. Tubercular pyelonephritic nonfunctioning kidney-another relative contraindication for laparoscopic nephrectomy: a case report. Transperitoneal nephrectomy for benign disease of the kidney: a comparison of laparoscopic and open surgical techniques. Laparoscopic renal ablation: an in vitro comparison of currently available electrical tissue morcellators. Laparoscopic nephrectomy for tuberculous nonfunctioning kidney: comparison with laparoscopic simple nephrectomy for other diseases. Comparison between standard flank versus laparoscopic nephrectomy for benign renal disease. A novel laparoscopic specimen entrapment device to facilitate morcellation of large renal tumors. Nephrectomy: a comparative study between the transperitoneal and retroperitoneal laparoscopic versus the open approach. Feasibility of laparoscopic approach in management of xanthogranulomatous pyelonephritis. The prevalence of simple renal and hepatic cysts detected by spiral computed tomography. Caliceal injury during laparoscopic cyst decortication in adult polycystic kidney disease. Bilateral laparoscopic nephrectomy for significantly enlarged polycystic kidneys: a technique to optimize outcome in the largest of specimens. Laparoscopic radical nephrectomy for renal cell carcinoma: oncological outcomes at 10 years or more. Prospective randomized comparison of transperitoneal versus retroperitoneal laparoscopic radical nephrectomy. Comparison of transperitoneal and retroperitoneal laparoscopic nephrectomy for renal cell carcinoma: a systematic review and meta-analysis. Approach and specimen handling do not influence oncological perioperative and long-term outcomes after laparoscopic radical nephrectomy. Retroperitoneal laparoscopic radical nephrectomy: the Cleveland Clinic experience. Long-term outcome of hand-assisted laparoscopic radical nephrectomy for localized stage T1/T2 renal-cell carcinoma. Operative safety and oncologic outcome of laparoscopic radical nephrectomy for renal cell carcinoma >7 cm: a multicenter study of 222 patients. Outcomes of laparoscopic radical nephrectomy in the setting of vena caval and renal vein thrombus: sevenyear experience. Laparoscopic radical nephrectomy for renal tumor: the Washington University Hospital experience. Retroperitoneoscopic radical nephrectomy with concomitant distal pancreatectomy: case report. Prospective, randomized controlled study: transperitoneal laparoscopic versus retroperitoneoscopic radical nephrectomy. Comparison of hand-assisted versus standard laparoscopic radical nephrectomy for suspected renal cell carcinoma. Hand-assisted laparoscopic nephrectomy: complications related to the hand-port site. The long-term outcome of laparoscopic radical nephrectomy for small renal cell carcinoma. Laparoscopic radical nephrectomy for large renal masses: critical assessment of perioperative and oncologic outcomes of stage T2a and T2b tumors. Long-term outcome of laparoscopic radical nephrectomy for pathologic T1 renal cell carcinoma. The roles of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy in management of pyelocaliceal diverticula.
Clinical correlates of renal angiomyolipoma subtypes in 209 patients: classic asthma humidity cheap 500mcg advair diskus with visa, fat poor asthma control definition discount advair diskus online master card, tuberous sclerosis associated and epithelioid asthma treatment long term effects purchase advair diskus 250mcg on-line. Growth rates of renal cell carcinoma and oncocytoma under surveillance are similar asthma management guidelines best advair diskus 250 mcg. Adult cystic nephroma and mixed epithelial and stromal tumor of the kidney are the same disease entity: molecular and histologic evidence. Simultaneous chromosome 7 and 17 gain and sex chromosome loss provide evidence that renal metanephric adenoma is related to papillary renal cell carcinoma. Gains of chromosomes 7, 17, 12, 16, and 20 and loss of Y occur early in the evolution of papillary renal cell neoplasia: a fluorescent in situ hybridization study. Metanephric adenoma lacks the gains of chromosomes 7 and 17 and loss of Y that are typical of papillary renal cell carcinoma and papillary adenoma. Laparoscopic management of peripelvic renal cysts: University of California, San Francisco, experience and review of literature. Prospective evaluation of fine needle aspiration of small, solid renal masses: accuracy and morbidity. Renal neoplasms in younger adults: analysis of 112 tumors from a single institution according to the new 2004 World Health Organization classification and 2002 American Joint Committee on Cancer Staging System. Pixel distribution analysis: can it be used to distinguish clear cell carcinomas from angiomyolipomas with minimal fat Percutaneous cryoablation of small kidney tumours under magnetic resonance imaging guidance: mediumterm follow-up. The efficacy and outcomes of urgent superselective transcatheter arterial embolization of patients with ruptured renal angiomyolipomas. Sclerotherapy of renal cysts using acetic acid: a comparison with ethanol sclerotherapy. Exophytic noninvasive growth pattern of renal angiomyolipomas: implications for nephron sparing surgery. Diagnostic value of cytokeratin 7 and parvalbumin in differentiating chromophobe renal cell carcinoma from renal oncocytoma. Renal oncocytoma: a reappraisal of morphologic features with clinicopathologic findings in 80 cases. Metanephric neoplasms: the hyperdifferentiated, benign end of the Wilms tumor spectrum The spectrum of metanephric adenofibroma and related lesions: clinicopathologic study of 25 cases from the National Wilms Tumor Study Group Pathology Center. S100 protein expression distinguishes metanephric adenomas from other renal neoplasms. Percutaneous treatment of simple renal cysts with n-butyl cyanoacrylate and iodized oil. Observation should be considered as an alternative in management of renal masses in older and comorbid patients. A classification of renal tumors with observations on the frequency of the various types. The role of partial nephrectomy for the management of sporadic renal angiomyolipoma. Hormone receptor expression in renal angiomyolipoma: clinicopathologic correlation. Cytologic features of metanephric adenoma of the kidney during pregnancy: a case report. Conservative treatment of renal angiomyolipomas in patients with tuberous sclerosis. Renal angiomyolipoma: selective arterial embolization-effectiveness and changes in angiomyogenic components in long-term follow-up. Renal cell carcinoma containing fat without associated calcifications: two case reports and review of literature. Lack of genetic changes at specific genomic sites separates renal oncocytomas from renal cell carcinomas. Renal neoplasia and acquired cystic kidney disease in patients receiving long-term dialysis. Intracystic hemorrhage in a patient of polycystic kidney with renocolic fistula diagnosed by contrast-enhanced ultrasonography. Conservative management of giant symptomatic angiomyolipomas in patients with the tuberous sclerosis complex. Diagnosis of renal angiomyolipoma with Hounsfield unit thresholds: effect of size of region of interest and nephrographic phase imaging. Sirolimus therapy for angiomyolipoma in tuberous sclerosis and sporadic lymphangioleiomyomatosis: a phase 2 trial. Renal oncocytoma: multifocality, bilateralism, metachronous tumor development and coexistent renal cell carcinoma. Identification and characterization of the tuberous sclerosis gene on chromosome 16.
Synchronized real-time ultrasonography and three-dimensional computed tomography scan navigation during percutaneous renal cryoablation in a porcine model asthma 101 asthma triggers handout buy advair diskus 500 mcg with mastercard. Contemporary management of renal cell carcinoma with coexistent renal artery disease: update of the Cleveland Clinic experience asthma symptoms during pregnancy discount advair diskus 500mcg fast delivery. Prevalence of renal cell carcinoma in patients with autosomal dominant polycystic kidney disease and chronic renal failure asthma symptoms neck pain discount advair diskus 500mcg free shipping. Accuracy of determining small renal mass management with risk stratified biopsies: confirmation by final pathology asthma symptoms flem buy genuine advair diskus on line. Natural history of renal cortical neoplasms during active surveillance with follow-up longer than 5 years. Targeting the hepatocyte growth factor/c-Met signaling pathway in renal cell carcinoma. Prospective clinical trial of preoperative sunitinib in patients with renal cell carcinoma. Partial nephrectomy for unilateral renal carcinoma and a normal contralateral kidney: 10-year followup. Spindle and cuboidal renal cell carcinoma, a tumour having frequent association with nephrolithiasis: report of 11 cases including a case with hybrid conventional renal cell carcinoma/spindle and cuboidal renal cell carcinoma components. Role of the vascular endothelial growth factor pathway in tumor growth and angiogenesis. Increasing incidence of all stages of kidney cancer in the last 2 decades in the United States: an analysis of surveillance, epidemiology and end results program data. Five-year survival after surgical treatment for kidney cancer: a population-based competing risk analysis. Partial nephrectomy versus radical nephrectomy in patients with small renal tumors-is there a difference in mortality and cardiovascular outcomes Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Renal cell carcinoma in relation to cigarette smoking: meta-analysis of 24 studies. Incidence, predictors and associated outcomes of renal cell carcinoma in long-term dialysis patients. Graft reconstruction of inferior vena cava for renal cell carcinoma stage pT3b or greater. Development and external validation of a new outcome prediction model for patients with clear cell renal cell 1364. Advanced-stage renal cell carcinoma treated by radical nephrectomy and adjacent organ or structure resection. Most renal oncocytomas appear to grow: observations of tumor kinetics with active surveillance. Carcinoid tumor of the kidney presenting as a large abdominal mass: report of a case. Molecular prognostic modeling using protein expression profile in clear cell renal carcinoma. Using tumor markers to predict the survival of patients with metastatic renal cell carcinoma. Assessment of the pathologic inclusion criteria from contemporary adjuvant clinical trials for predicting disease progression after nephrectomy for renal cell carcinoma. What does the urologist expect from the pathologist (and what can the pathologists give) in reporting on adult kidney tumour specimens Distinct patterns of chromosomal losses in clinically synchronous and asynchronous bilateral renal cell carcinoma. Fuhrman grade provides higher prognostic accuracy than nucleolar grade for papillary renal cell carcinoma. Active surveillance of small renal masses: progression patterns of early stage kidney cancer. Progress in nephron sparing therapy for renal cell carcinoma and von Hippel-Lindau disease. Analysis of complications following partial and total nephrectomy for renal cancer in a population based sample. Clonal origin of multifocal renal cell carcinoma as determined by microsatellite analysis. Accuracy of breath-hold magnetic resonance imaging in preoperative staging of organ-confined renal cell carcinoma. A systematic review of the quality of evidence of ablative therapy for small renal masses. Laparoscopic cryoablation versus partial nephrectomy for the treatment of small renal masses: systematic review and cumulative analysis of observational studies. Prognostic impact of tumor size on pT2 renal cell carcinoma: an international multicenter experience. Cytogenetic profile predicts prognosis of patients with clear cell renal cell carcinoma. Development and external validation of a nomogram predicting disease specific survival after nephrectomy for papillary renal cell carcinoma. Molecular signatures of localized clear cell renal cell carcinoma to predict disease-free survival after nephrectomy. Sunitinib mediates reversal of myeloid-derived suppressor cell accumulation in renal cell carcinoma patients. Collecting duct carcinoma of the kidney: an immunohistochemical evaluation of the use of antibodies for differential diagnosis.
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The radiographic features include thickened irregular or smooth walls or septa in which measurable enhancement can be observed asthmatic bronchitis and pregnancy discount advair diskus 500mcg visa. About 50% of these lesions are malignant; the remainder prove to be benign multiloculated asthma treatment in children purchase 500 mcg advair diskus mastercard, hemorrhagic asthma flare up cheap advair diskus online american express, or densely calcified cysts (see Box 57-2) asthmatic bronchitis medications proven advair diskus 250mcg. Fine-needle aspiration of complex cysts is rarely performed because of concern about sampling error and tumor cell spillage. Five-year relative survival rates for patients diagnosed in 2002 to 2008 were 71% for kidney cancer, 78% for bladder cancer (excluding carcinoma in situ), and 99% for prostate cancer (Siegel et al, 2013). Overall, approximately 12 new cases are diagnosed per 100,000 population per year, with a male-to-female predominance of 3: 2 (Siegel et al, 2013). This is primarily a disease of older adults, with typical presentation between 50 and 70 years of age (Pantuck et al, 2001b; Wallen et al, 2007; Siegel et al, 2013). However, diagnosis of renal cancer has increased more rapidly in those less than 40 years of age than any other age group (Nepple et al, 2012). Incidence rates are 10% to 20% higher and 5-year survival rates 5% lower in African-Americans for unknown reasons (Lipworth et al, 2006; Stafford et al, 2008; Chow et al, 2013; Siegel et al, 2013). This trend has correlated with an increased proportion of incidentally discovered and localized tumors and with improved 5-year survival rates for patients with this stage of disease (Pantuck et al, 2001b; Parsons et al, 2001; Kane et al, 2008). This rising mortality rate is particularly troubling because the proportion of advanced tumors has actually decreased (Wallen et al, 2007; Decastro and McKiernan, 2008; Siegel et al, 2013). This suggests that a deleterious change in tumor biology may have occurred during the past several decades, perhaps related to tobacco use, dietary factors, or exposure to other carcinogens (Pantuck et al, 2001b; Parsons et al, 2001; Hock et al, 2002; Kane et al, 2008). Mean age at presentation in children is 8 to 9 years, and the incidence is similar in boys and in girls. All forms of tobacco use have been implicated, and risk increases with cumulative dose or pack-years. Relative risk is directly related to duration of smoking and begins to fall after cessation, further supporting a cause-andeffect relationship (Parker et al, 2003b; Hunt et al, 2005; Ljungberg et al, 2011). The proposed mechanisms are hypertensioninduced renal injury and inflammation or metabolic or functional changes in the renal tubules that may increase susceptibility to carcinogens (Lipworth et al, 2006; Ljungberg et al, 2011). The potential role of trichloroethylene exposure has been actively investigated; some studies showed relative risks ranging from twofold to sixfold, but others have argued that inherent biases likely account for these results (Kelsh et al, 2010). Other potential iatrogenic causes include regular usage of nonsteroidal anti-inflammatory drugs, which was associated with a relative risk of 1. Knudson and Strong recognized that familial forms of cancer might hold the key to the identification of important regulatory elements known as tumor suppressor genes (Knudson, 1971; Knudson and Strong, 1972). Their observations about the childhood tumor retinoblastoma, in which familial cases tend to be multifocal and early onset, led them to propose a two-hit theory of carcinogenesis. They hypothesized that a gene product that could suppress tumor development must be involved and that both alleles of this "tumor suppressor gene" must be mutated or inactivated for tumorigenesis to occur. Furthermore, Knudson postulated that patients with familial cancers are born with one mutant allele and that all cells in that organ or tissue are at risk, accounting for the early onset and multifocal nature of the disease. In contrast, sporadic tumors develop only if a mutation occurs in both alleles within the same cell; and because each event occurs with low frequency, most tumors develop late in life and in a unifocal manner (Knudson, 1971; Knudson and Strong, 1972). This is a relatively rare autosomal dominant disorder that occurs with a frequency of 1 per 36,000 population. All of these tumor types are highly vascular and can lead to substantial morbidity, much of which can be avoided with prompt recognition and careful, skilled management. In particular, central nervous system lesions can lead to paralysis or death and retinal lesions to blindness if they are not identified and managed in an expedient manner. Other common or important manifestations of von Hippel-Lindau disease include renal and pancreatic cysts, inner ear tumors, and papillary cystadenomas of the epididymis (Neumann and Zbar, 1997). An increased incidence of neuroendocrine tumors of the pancreas has also been reported in von Hippel-Lindau disease (Zbar et al, 1999). Penetrance for all of these traits is far from complete, and some, such as pheochromocytomas, tend to be clustered only in certain families (Table 57-4) (Neumann and Zbar, 1997). These studies demonstrated a common loss of chromosome 3 in kidney cancer, particularly the clear cell variant, and led to intensive efforts to find a tumor suppressor gene in this region (Zbar et al, 1987; Seizinger et al, 1988). Reports by Kovacs and colleagues (1989a) and Cohen and colleagues (1979) of translocations involving chromosome 3 further implicated this chromosome as an important regulatory element. A large number of common mutations or "hot spots" in the gene have been identified, and a direct correlation between genotype and phenotype has been established in some cases (McNeill et al, 2009). For instance, missense mutations (type 2 mutations) that result in a full-length but nonfunctional protein are commonly found in families with von Hippel-Lindau disease that develop pheochromocytomas, whereas deletions leading to a truncated protein (type 1 mutations) are typically found in families that do not develop pheochromocytomas (see Table 57-4) (McNeill et al, 2009). The identification of this tumor suppressor gene represented a major advance in the field and required close collaboration between clinical urologic oncologists and molecular geneticists. Again, autosomal dominant inheritance was observed, and this appears to be a tumor suppressor gene rather than an oncogene. Fumarate hydratase is an essential enzyme in the Krebs cycle of oxidative metabolism. The exact mechanisms by which this leads to malignancy are still under investigation, although hypotheses about this date back to the 1920s and the proposed Warburg effect. This in turn may lead to increased expression of growth factors and thus promote tumorigenesis. In contrast, almost all individuals with this syndrome will develop cutaneous leiomyomas and uterine fibroids (if female), usually manifesting at the age of 20 to 35 years.
