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Abstract
RCC is the most common renal neoplasm with increasing incidence in the last few years.
The last decade has brought-dramatic changes in understanding of localized renal tumors. Due to the fast improvement in the obtained imaging modalities of computed tomography (CT), ultrasound and magnetic resonance imaging (MRI).
Now there are recent modalities for management of localized renal tumors such as: Laparoscopic partial nephrectomy, which is performed in patients with renal lesion with risk for postoperative renal insufficiency (anatomically functioning solitary kidney, bilateral lesions, significant preoperative renal insufficiency or risk factor for future renal disease).
Also energy based techniques for nephron-sparing surgery are one of the most recent trends in treatment of localized renal tumors.
1- Radiofrequency ablation.
2- Cryoablation.
3- High intensity focused ultrasound.
These are less invasive techniques and also can be used when surgery is contraindicated. These can be done, laparoscopically, percutaneously. Percutaneous ablation using these techniques is a promising minimally invasive modality to treat renal masses smaller than 4cm in select patients. Short term data demonstrate adequate oncological control and low complication rates. Improvement in real time imaging will allow for more widespread use of percutaneous treatment, long-term follow-up will ultimately provide us with answers as to the durability of percutaneous techniques.
Future can bring to us new modalities for tumor ablation and new techniques for access which are not familiar till now. Green laser is one of the recent technique in ablation of the prostatic tissue may be used in the future in management of localized renal tumors.