Our Summary

This research paper is about two studies conducted to better understand how kidney tumors affect the lymphatic system, which is part of the body’s immune system. The researchers used a technique called sentinel lymph node imaging and biopsy, which helps to identify the first lymph node(s) to which cancer cells are likely to spread from a primary tumor.

The paper includes the analysis of 73 patients who had kidney tumors of a certain size and underwent surgery to remove either the whole kidney or part of it. The surgeries also included a procedure to detect and remove certain lymph nodes during the operation. Some patients had open surgery, some had a type of keyhole surgery called laparoscopic, and some had robot-assisted keyhole surgery.

The results showed that no serious complications occurred during the operation. After the surgery, there were complications in about 16.4% of patients, but most of these were minor. There were no significant differences in complications or severity of complications between the different types of surgery.

The blood loss and length of the procedure varied, but the median blood loss was less for surgeries that removed only part of the kidney, and the length of the procedure was slightly longer for robot-assisted surgeries.

The researchers concluded that adding the procedure to detect and remove certain lymph nodes during kidney surgery is safe. The rate of complications is low and does not differ between the different types of surgery.

FAQs

  1. What is the purpose of sentinel lymph node imaging and biopsy in kidney tumor surgeries?
  2. What were the results of the studies regarding complications during and after kidney surgeries?
  3. Did the type of surgery (open, laparoscopic, robot-assisted) have any impact on the rate of complications or severity of complications in these studies?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sentinel lymph node biopsy is to follow post-operative care instructions carefully to reduce the risk of complications and promote proper healing. This may include keeping the surgical site clean and dry, avoiding heavy lifting or strenuous activity, taking prescribed medications as directed, and attending follow-up appointments with your healthcare provider. It is also important to monitor for any signs of infection, such as increased pain, redness, swelling, or drainage at the surgical site, and to contact your doctor if you experience any of these symptoms.

Suitable For

Patients who are typically recommended sentinel lymph node biopsy include those with kidney tumors of a certain size who are undergoing surgery to remove either the whole kidney or part of it. This procedure may be recommended to help identify the first lymph node(s) to which cancer cells are likely to spread from a primary tumor. The procedure may be performed during open surgery, laparoscopic surgery, or robot-assisted keyhole surgery. The study mentioned in the research paper found that the procedure is safe, with low rates of complications, and no significant differences in complications between the different types of surgery.

Timeline

  • Before sentinel lymph node biopsy:
  1. Patient is diagnosed with a kidney tumor and undergoes imaging tests to determine the size and location of the tumor.
  2. Patient discusses treatment options with their healthcare provider, including surgery to remove the tumor.
  3. Patient is informed about the possibility of undergoing a sentinel lymph node biopsy to determine if the cancer has spread to nearby lymph nodes.
  4. Patient may undergo additional tests or evaluations to determine if they are a suitable candidate for the procedure.
  5. Patient undergoes surgery to remove the kidney tumor and sentinel lymph node biopsy is performed during the operation.
  • After sentinel lymph node biopsy:
  1. Patient is monitored for any complications or side effects following the surgery.
  2. Results of the biopsy are analyzed to determine if cancer cells are present in the sentinel lymph nodes.
  3. If cancer cells are found, further treatment options may be discussed with the patient, such as additional surgery, chemotherapy, or radiation therapy.
  4. Patient may undergo regular follow-up appointments and imaging tests to monitor for any signs of cancer recurrence.
  5. Patient continues with any recommended treatments or therapies as part of their cancer care plan.

What to Ask Your Doctor

  1. What is a sentinel lymph node biopsy and how is it performed?
  2. Why is a sentinel lymph node biopsy recommended for my specific case?
  3. What are the potential risks and complications associated with a sentinel lymph node biopsy?
  4. How will the results of the sentinel lymph node biopsy impact my treatment plan?
  5. Will I need any additional treatments or follow-up care based on the results of the biopsy?
  6. How experienced are you in performing sentinel lymph node biopsies for kidney tumors?
  7. Are there any alternative procedures or tests that can provide similar information to a sentinel lymph node biopsy?
  8. How soon will I receive the results of the biopsy?
  9. What should I expect in terms of recovery and post-operative care after a sentinel lymph node biopsy?
  10. Are there any specific lifestyle changes or precautions I should take following the biopsy?

Reference

Authors: Kuusk T, Brouwer O, Graafland N, Hendricksen K, Donswijk M, Bex A. Journal: Urology. 2019 Aug;130:186-190. doi: 10.1016/j.urology.2019.04.026. Epub 2019 Apr 30. PMID: 31051164