Editing Open Kidney Surgery (section)

== Answers ==

# What are the potential benefit of renal artery embolization prior to nephrectomy?
## Shrinkage of an arterialized tumor thrombus to ease surgical removal
## Reduced blood loss
## Facilitation of dissection as a result of tissue plane edema
## Modulation of immune response
## Ability to ligate the renal vein before the renal artery
# What are the indications for an adrenalectomy during radical nephrectomy?
## Adrenal mass on imaging
## Tumor thrombus
## Lymphadenopathy and regional metastasis
## Extrarenal tumor extension
## Large tumor size (>10 cm)
## Advanced stage (T3)
## Large upper pole tumors (>7cm) when the surgical plane between the kidney and adrenal gland may be compromised
## Diffuse involvement by tumor
# What are the indications for regional lymphadenectomy at the time of radical nephrectomy?
## Enlarged lymph nodes on imaging
## Cytoreductive surgery for metastatic disease
## Tumor size > than 10 cm
## Nuclear grade 3 or 4
## Sarcomatoid component
## Presence of tumor necrosis on imaging
## Extrarenal tumor extension
## Tumor thrombus
## Direct tumoral invasion of adjacent organs
# When is a patch cavoplasty required during surgery for RCC with IVC thrombus?
#* If the IVC lumen is expected to be < 50% of its original size
# Patency of which artery is necessary for safe ligation of the inferior mesenteric artery?
#* Marginal artery of the colon
# Describe the staging of IVC thrombi
#* Level 0: no thrombus
#* Level I: within 2cm of renal vein ostium
#* Level II: below hepatic veins
#* Level III: between hepatic veins and diaphragm
#* Level IV: above diaphragm
# What is a potential consequence of ligating the superior mesenteric vein?
#* Abdominal compartment syndrome; the abdomen should not be closed if the superior mesenteric vein is ligation