| Abstract [eng] |
In the modern world, with the increasing number of diagnosed cases of kidney cancer, there is a need to use such treatment methods that would be not only oncologically effective, but also would not worsen the patient's quality of life. This is why nephron-sparing treatment is becoming relevant, as it is a safe and effective alternative to radical nephrectomy, which is a risk factor for chronic kidney disease. This thesis presents an extensive literature review, discussing the latest information on the clinical, diagnostic and treatment features of nephron-sparing treatment, and an illustrative clinical case. In the treatment of large (>4 cm) kidney tumors, it is important to individually assess the patient's age, comorbidities, and functional status to choose the optimal nephron sparing treatment method. Nephron-sparing surgeries (renal resection) are recommended not only for T1a–T1b stage tumors, but also for larger ones, if the tumor localization and surgical experience allow. They preserve better kidney function and reduce the patient's risk of chonic kidney disease, but are technically more complex. Alternative methods, such as radiofrequency, cryo- or microwave ablation, are used in patients for whom surgery would be too risky, however they are equally as effective controlling oncological illness as kidney resection. The clinical case presented is a T1b stage renal tumor treated with cryoablation in a patient for whom surgery was contraindicated due to concomitant oncological disease. The treatment was successful, and the results confirmed the effectiveness and safety of this method. The conclusions of the work emphasize the importance of individualized treatment selection and prove that even for large renal tumors, it is possible to preserve kidney function. |
