Editorial comment.

Abstract

Some recent studies have suggested that there may be a benefit in sparing nephrons in the treatment of renal tumors. 1 Weight C.J. Larson B.T. Fergany A.F. et al. Nephrectomy induced chronic renal insufficiency is associated with increased risk of cardiovascular death and death from any cause in patients with localized cT1b renal masses. J Urol. 2010; 183: 1317-1323 Abstract Full Text Full Text PDF PubMed Scopus (351) Google Scholar , 2 Huang W.C. Elkin E.B. Levey A.S. et al. Partial nephrectomy versus radical nephrectomy in patients with small renal tumors—is there a difference in mortality and cardiovascular outcomes?. J Urol. 2009; 181: 55-62 Abstract Full Text Full Text PDF PubMed Scopus (675) Google Scholar , 3 Kim S.P. Thompson R.H. Boorjian S.A. et al. Comparative effectiveness for survival and renal function of partial and radical nephrectomy for localized renal tumors: a systematic review and meta-analysis. J Urol. 2012; 188: 51-57 Abstract Full Text Full Text PDF PubMed Scopus (291) Google Scholar , 4 Tan H.J. Norton E.C. Ye Z. et al. Long-term survival following partial vs radical nephrectomy among older patients with early-stage kidney cancer. JAMA. 2012; 307: 1629-1635 Crossref PubMed Scopus (419) Google Scholar Partial nephrectomy with vascular clamping has emerged as the primary method of nephron sparing because it has the longest track record, 5 Fergany A.F. Hafez K.S. Novick A.C. Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urol. 2000; 163: 442-445 Abstract Full Text Full Text PDF PubMed Scopus (965) Google Scholar is associated with equivalent cancer-specific survival compared with radical nephrectomy, 6 Van Poppel H. Da Pozzo L. Albrecht W. et al. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol. 2011; 59: 543-552 Abstract Full Text Full Text PDF PubMed Scopus (765) Google Scholar preserves renal function, 1 Weight C.J. Larson B.T. Fergany A.F. et al. Nephrectomy induced chronic renal insufficiency is associated with increased risk of cardiovascular death and death from any cause in patients with localized cT1b renal masses. J Urol. 2010; 183: 1317-1323 Abstract Full Text Full Text PDF PubMed Scopus (351) Google Scholar and can be performed through both open and minimally invasive techniques. 7 Gill I.S. Kavoussi L.R. Lane B.R. et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol. 2007; 178: 41-46 Abstract Full Text Full Text PDF PubMed Scopus (958) Google Scholar More recently, selective arterial clamping has emerged as an alternative method of nephron-sparing surgery (references 1-3 in the article). This has been proposed as a way to limit global ischemia and hopefully minimize the reduction in GFR associated with complete hilar clamping. Application of Combined Computed Tomography Arteriography, Venography, and Urography in Laparoscopic Partial Nephrectomy With Segmental Artery ClampingUrologyVol. 84Issue 6PreviewTo evaluate the role of combined computed tomography (CT) arteriography (CTA), venography, and urography in laparoscopic partial nephrectomy (LPN) with segmental renal artery clamping. Full-Text PDF ReplyUrologyVol. 84Issue 6PreviewWe sincerely appreciate the comments and critiques of our work. It is noteworthy that partial nephrectomy with highly selective clamping has become an important technique to protect the affected kidney from warm ischemic (WI) injury.1 Besides the skillful laparoscopic technique required, precise preoperative radiologic imaging is essential to establish the intrahilar orientation to the necessary level of detail, and our combined imaging model is intended to achieve this. Full-Text PDF