Intraoperative sonography for the evaluation and management of XXXX : experience with 100 @entity1 .

@entity1 @entity8 @entity5 @entity703
PURPOSE: Intraoperative sonography was used to evaluate prospectively the renal parenchyma of @entity1 undergoing surgery for presumed @entity8 . MATERIALS AND METHODS: One surgeon (F.F.M.) evaluated 100 kidneys using a triple-head sector ultrasonic transducer (5 MHz., 7.5 MHz. and 10 MHz. with duplex Doppler imaging). The size, number, echo texture, location, and relationship of suspected lesions to the collecting system, vasculature and renal capsule were recorded. Real-time Doppler imaging was used to distinguish among renal arteries, renal veins and the collecting system. Sonography was used to delineate the extent of the @entity5 and presence or absence of satellite lesions. All @entity1 were evaluated preoperatively with abdominal computerized tomography. RESULTS: Under ultrasonic guidance partial nephrectomy was done in 40 cases, radical nephrectomy in 56, unroofing of @entity8 in 3 and renal biopsy in 1. Of the @entity1 8 were considered candidates for partial nephrectomy but underwent radical nephrectomy after intraoperative sonography revealed more extensive @entity5 , especially at the renal hilum. Similarly, 3 @entity1 with a suspected @entity5 were spared nephrectomy after intraoperative sonography and frozen section analysis revealed benign multilocular cysts. All surgical margins after sonographic evaluation were negative in @entity1 undergoing partial nephrectomy. CONCLUSIONS: Intraoperative ultrasound is a useful adjunct for the dynamic evaluation of @entity703 in the surrounding environment of @entity8 , the collecting system and the renal vasculature. It is particularly beneficial in defining preoperative @entity8 and in evaluating extrarenal structures for @entity5 involvement, such as the renal vein, inferior vena cava, adrenal gland and liver. Intraoperative sonography is most useful during partial nephrectomy and may improve @entity5 -free surgical margins. Sonography is routinely used during partial nephrectomy.
