Tratamento cirúrgico de múltiplos renais na síndrome de Von Hippel-Lindau: relato de caso e revisão de literatura

Detalhes bibliográficos
Autor(a) principal: Ferreira, Marina Guimarães
Data de Publicação: 2020
Tipo de documento: Trabalho de conclusão de curso
Idioma: por
Título da fonte: Repositório do Centro Universitário Braz Cubas
Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/1447
Resumo: Von Hippel-Lindau disease (VHL) is an autosomal dominant genetic condition associated with mutations in the VHL tumor suppressor gene. The most common clinical presentations are tumors of the central nervous system (CNS), retina, kidney, pancreas, pheochromocytomas and simple cysts in solid organs. Renal involvement is cysts and clear cell renal carcinoma. The diagnosis of the disease is based on well-defined clinical criteria and genetic testing. It was noticed that the number of deaths due to RCC decreased over the period, most likely due to the benefits of regular surveillance protocols and the preservation of renal function, promoted by the change in treatment. The surgical approach went from radical nephrectomy associated with dialysis to nephron-sparing approaches, with emphasis on partial nephrectomy. The present study proposes to report the case of a patient, with von Hippel-Lindau disease, who underwent surgical treatment of multiple kidney tumors. The surgical technique and perioperative results were described. The results were analyzed based on the correlation with the literature review. This is an observational, single-arm, descriptive, case report type study, based on retrospective information obtained from the patient's medical record. Clinical history, laboratory exams, image exams, videos of the surgeries performed, description of the surgical technique and pre, trans and postoperative elements were analyzed. The research was approved by the Research Ethics Committee (CEP) and generated the Presentation Certificate for Ethical Appreciation (CAAE) 30549420.9.0000.5176. The patient, with von HippelLindau syndrome, was forwarding renal tumors in both kidneys, with an R.E.N.A.L. 9x and 10x in the right kidney and 11p in the left kidney. He underwent partial laparoscopic nephrectomies, without peri and postoperative complications. It is monitored under active surveillance through MRI of the abdomen annually Enucleation of tumors, associated with techniques that prevent complete ischemia of the kidney, are the main strategies used in order to preserve parenchyma and minimize kidney damage. The laparoscopic approach is a minimally invasive form that can assist in the treatment of renal nodules, especially in those patients who require multiple surgical resections, giving less surgical morbidity. Active surveillance of the kidneys, based on frequent serial examinations, enables cancer control and prevents metastatic disease. Tumors smaller than 3 centimeters can generally be conservative. Strict monitoring ensures that the appropriate time for surgical treatment is defined.
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spelling Tratamento cirúrgico de múltiplos renais na síndrome de Von Hippel-Lindau: relato de caso e revisão de literaturaDoença de von Hippel-LindauCâncer renalNefrectomiaCNPQ::CIENCIAS DA SAUDE::MEDICINAVon Hippel-Lindau disease (VHL) is an autosomal dominant genetic condition associated with mutations in the VHL tumor suppressor gene. The most common clinical presentations are tumors of the central nervous system (CNS), retina, kidney, pancreas, pheochromocytomas and simple cysts in solid organs. Renal involvement is cysts and clear cell renal carcinoma. The diagnosis of the disease is based on well-defined clinical criteria and genetic testing. It was noticed that the number of deaths due to RCC decreased over the period, most likely due to the benefits of regular surveillance protocols and the preservation of renal function, promoted by the change in treatment. The surgical approach went from radical nephrectomy associated with dialysis to nephron-sparing approaches, with emphasis on partial nephrectomy. The present study proposes to report the case of a patient, with von Hippel-Lindau disease, who underwent surgical treatment of multiple kidney tumors. The surgical technique and perioperative results were described. The results were analyzed based on the correlation with the literature review. This is an observational, single-arm, descriptive, case report type study, based on retrospective information obtained from the patient's medical record. Clinical history, laboratory exams, image exams, videos of the surgeries performed, description of the surgical technique and pre, trans and postoperative elements were analyzed. The research was approved by the Research Ethics Committee (CEP) and generated the Presentation Certificate for Ethical Appreciation (CAAE) 30549420.9.0000.5176. The patient, with von HippelLindau syndrome, was forwarding renal tumors in both kidneys, with an R.E.N.A.L. 9x and 10x in the right kidney and 11p in the left kidney. He underwent partial laparoscopic nephrectomies, without peri and postoperative complications. It is monitored under active surveillance through MRI of the abdomen annually Enucleation of tumors, associated with techniques that prevent complete ischemia of the kidney, are the main strategies used in order to preserve parenchyma and minimize kidney damage. The laparoscopic approach is a minimally invasive form that can assist in the treatment of renal nodules, especially in those patients who require multiple surgical resections, giving less surgical morbidity. Active surveillance of the kidneys, based on frequent serial examinations, enables cancer control and prevents metastatic disease. Tumors smaller than 3 centimeters can generally be conservative. Strict monitoring ensures that the appropriate time for surgical treatment is defined.A síndrome de von Hippel-Lindau (VHL) é uma condição genética autossômica dominante associada a mutações no gene supressor de tumor VHL. As apresentações clínicas mais comuns são tumores de sistema nervoso central (SNC), de retina, de rim, de pâncreas, feocromocitomas e cistos simples em órgãos sólidos. O acometimento renal é de cistos e carcinoma renal de células claras. O diagnóstico da doença é feito a partir de critérios clínicos bem delimitados e do teste genético. A síndrome de von Hippel-Lindau é a principal causa de carcinoma de células renais hereditário. Percebeu-se que o número de mortes por CCR diminuiu ao longo do período, muito provavelmente devido aos benefícios dos protocolos regulares de vigilância e da preservação da função renal, promovida pela mudança do tratamento. A abordagem cirúrgica passou de nefrectomia radical associada à diálise para abordagens poupadoras de néfrons, destacando-se a nefrectomia parcial. O presente estudo propõe relatar o caso de um paciente, portador de síndrome de von Hippel-Lindau, submetido ao tratamento cirúrgico de múltiplos tumores renais. Foi descrita a técnica cirúrgica e os resultados perioperatórios. Os resultados foram analisados a partir da correlação com a revisão de literatura. Trata-se de um estudo observacional e de braço único, descritivo, do tipo relato de caso, a partir de informações retrospectivas, obtidas através do prontuário do paciente. Foram analisados história clínica, exames laboratoriais, exames de imagem, vídeos das cirurgias realizadas, descrição da técnica cirúrgica e elementos pré, trans e pósoperatórios. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa (CEP) e gerou o Certificado de Apresentação para Apreciação Ética (CAAE) 30549420.9.0000.5176. O paciente, portador de síndrome de von Hippel-Lindau, foi encaminhando tumores renais em ambos os rins, de escore R.E.N.A.L. 9x e 10x em rim direito e 11p em rim esquerdo. Foi submetido a nefrectomias parciais laparoscópicas, sem complicações peri e pós-operatórias. É acompanhado sob vigilância ativa através de ressonância magnética de abdome anualmente. A enucleação dos tumores, associada a técnicas que permitam evitar a isquemia completa do rim, são as principais estratégias utilizadas, com a finalidade de preservar parênquima e minimizar o dano renal. A via laparoscópica é uma forma minimamente invasiva que pode que auxiliar no tratamento dos nódulos renais, especialmente naqueles pacientes que necessitem de múltiplas ressecções cirúrgicas, conferindo menor morbidade cirúrgica. A vigilância ativa dos rins, a partir de exames seriados frequentes, viabiliza o controle oncológico e evita a doença metastática. Os tumores menores que 3 centímetros geralmente podem ter conduta conservadora. O acompanhamento rigoroso garante definir o momento adequado para o tratamento cirúrgico.Centro Universitário de João PessoaBrasilUNIPÊRebouças, Rafael Batistahttp://lattes.cnpq.br/4418656802605634Ferreira, Marina Guimarães2021-02-03T12:35:04Z2021-02-042021-02-03T12:35:04Z2020-12-21info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/bachelorThesisapplication/pdfhttps://repositorio.cruzeirodosul.edu.br/handle/123456789/1447porAMIN, Mahul B. et al. (org.). AJCC Cancer Staging Manual. Cham: Springer International Publishing, 2017. E-book. Disponível em: http://www.cancerstaging.org/staging/PDFs/washington-stomach.pdf BRAVI, Carlo Andrea et al. Perioperative Outcomes of Open, Laparoscopic, and Robotic Partial Nephrectomy: A Prospective Multicenter Observational Study (The RECORd 2 Project). European Urology Focus, [S. l.], p. 1–7, 2019. Disponível em: https://doi.org/10.1016/j.euf.2019.10.013 BERG, Jonathan S. et al. Processes and preliminary outputs for identification of actionable genes as incidental findings in genomic sequence data in the Clinical Sequencing Exploratory Research Consortium. Genetics in Medicine, [S. l.], v. 15, n. 11, p. 860–867, 2013. BINDERUP, Marie Louise Mølgaard et al. Von Hippel-Lindau disease (vHL). National clinical guideline for diagnosis and surveillance in Denmark. 3rd edition. Danish medical journal, [S. l.], v. 60, n. 12, p. B4763, 2013. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/24355456 BINDERUP, Marie Louise Mølgaard et al. Survival and causes of death in patients with von Hippel-Lindau disease. Journal of Medical Genetics, [S. l.], v. 54, n. 1, p. 11–18, 2017. Disponível em: http://jmg.bmj.com/lookup/doi/10.1136/jmedgenet-2016- 104058 BRATSLAVSKY, Gennady et al. Salvage Partial Nephrectomy for Hereditary Renal Cancer: Feasibility and Outcomes. Journal of Urology, [S. l.], v. 179, n. 1, p. 67–70, 2008. BRATSLAVSKY, Gennady; LINEHAN, W. Marston. Long-term management of bilateral, multifocal, recurrent renal carcinoma. Nature Reviews Urology, [S. l.], v. 7, n. 5, p. 267–275, 2010. Disponível em: http://dx.doi.org/10.1038/nrurol.2010.44 CACCIAMANI, Giovanni E. et al. Impact of Renal Hilar Control on Outcomes of Robotic Partial Nephrectomy: Systematic Review and Cumulative Meta-analysis. European Urology Focus, [S. l.], v. 5, n. 4, p. 619–635, 2019. CAMPBELL, Steven et al. Renal Mass and Localized Renal Cancer: AUA Guideline. Journal of Urology, [S. l.], v. 198, n. 3, p. 520–529, 2017. Disponível em: http://dx.doi.org/10.1016/j.juro.2017.04.100 CHOUEIRI, Toni K. et al. Phase I/II study of the oral HIF-2 α inhibitor MK-6482 in patients with advanced clear cell renal cell carcinoma (RCC). Journal of Clinical Oncology, [S. l.], v. 38, n. 6_suppl, p. 611, 2020. Disponível em: https://doi.org/10.1200/JCO.2020.38.6_suppl.611 COLLINS, Edward Treacher. Intra-ocular growths. I. Two cases, brother and sister, with peculiar vascular new growth, probably primary retinal, affected both eyes. Trans Ophthalmol Soc U K, [S. l.], v. 14, p. 141, 1894. DAUGHERTY, Michael; BRATSLAVSKY, Gennady. Surgical Techniques in the Management of Small Renal Masses. Urologic Clinics of North America, [S. l.], v. 44, n. 2, p. 233–242, 2017. Disponível em: http://dx.doi.org/10.1016/j.ucl.2016.12.009 FADAHUNSI, Amaka T. et al. Feasibility and Outcomes of Partial Nephrectomy for Resection of at Least 20 Tumors in a Single Renal Unit. Journal of Urology, [S. l.], v. 185, n. 1, p. 49–53, 2011. Disponível em: http://dx.doi.org/10.1016/j.juro.2010.09.032 FETNER, C. D. et al. Bilateral renal cell carcinoma in von Hippel Lindau syndrome: treatment with staged bilateral nephrectomy and hemodialysis. Journal of Urology, [S. l.], v. 117, n. 4, p. 534–536, 1977. Disponível em: http://dx.doi.org/10.1016/S0022-5347(17)58523-7 FINDEIS-HOSEY, Jennifer; MCMAHON, Kelly; FINDEIS, Sarah. Von Hippel–Lindau Disease. Journal of Pediatric Genetics, [S. l.], v. 05, n. 02, p. 116–123, 2016. Disponível em: https://www.mdanderson.org/cancer-types/von-hippel-lindaudisease/von-hippel-lindau-disease-treatment.html GO, Alan S. et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. New England Journal of Medicine, [S. l.], v. 351, n. 13, p. 1296–1305, 2004. HOFFMAN, M. A. von Hippel-Lindau protein mutants linked to type 2C VHL disease preserve the ability to downregulate HIF. Human Molecular Genetics, [S. l.], v. 10, n. 10, p. 1019–1027, 2001. HUANG, William C. et al. Partial Nephrectomy Versus Radical Nephrectomy in Patients With Small Renal Tumors-Is There a Difference in Mortality and Cardiovascular Outcomes? Journal of Urology, [S. l.], v. 181, n. 1, p. 55–62, 2009. JONASCH, E. et al. Pilot trial of sunitinib therapy in patients with von Hippel-Lindau disease. Annals of Oncology, [S. l.], v. 22, n. 12, p. 2661–2666, 2011. Disponível em: https://academic.oup.com/annonc/article-lookup/doi/10.1093/annonc/mdr011 KAELIN, W. G. Molecular basis of the VHL hereditary cancer syndrome. Nature Reviews Cancer, [s. l.], v. 2, n. 9, p. 673–682, 2002. Disponível em: <http://www.nature.com/articles/nrc885> KRUIZINGA, Roeliene C. et al. Calculating optimal surveillance for detection of von Hippel–Lindau-related manifestations. Endocrine-Related Cancer, [S. l.], v. 21, n. 1, p. 63–71, 2014. Disponível em: https://erc.bioscientifica.com/view/journals/erc/21/1/63.xml LINDAU, Arvind. Zur Frage der Angiomatosis Retinae und Ihrer Hirncomplikation. Acta Ophthalmol. 4, 193 – 226 (1927). Acta Ophthalmol, [S. l.], v. 226, p. 1927, 1927. LONSER, Russell R. et al. von Hippel-Lindau disease. Lancet (London, England), [S. l.], v. 361, n. 9374, p. 2059–67, 2003. 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Minerva Urologica e Nefrologica, [S. l.], v. 69, n. 6, p. 523–538, 2017. NIELSEN, Sarah M. et al. Von Hippel-Lindau disease: Genetics and role of genetic counseling in a multiple neoplasia syndrome. Journal of Clinical Oncology, [S. l.], v. 34, n. 18, p. 2172–2181, 2016. PIERORAZIO, Phillip M. et al. Management of Renal Masses and Localized Renal Cancer: Systematic Review and Meta-Analysis. Journal of Urology, [S. l.], v. 196, n. 4, p. 989–999, 2016. Disponível em: http://dx.doi.org/10.1016/j.juro.2016.04.081 REDNAM, Surya P. et al. Von Hippel-Lindau and hereditary pheochromocytoma/paraganglioma syndromes: Clinical features, genetics, and surveillance recommendations in childhood. Clinical Cancer Research, [S. l.], v. 23, n. 12, p. e68–e75, 2017. REED, Amanda Beth; PAREKH, Dipen J. Surgical Management of von Hippel-Lindau Disease: Urologic Considerations. Surgical Oncology Clinics of North America, [S. l.], v. 18, n. 1, p. 157–174, 2009. Disponível em: http://dx.doi.org/10.1016/j.soc.2008.08.005 STEINBACH, F. et al. Treatment of renal cell carcinoma in von Hippel-Lindau disease: a multicenter study. The Journal of urology, [S. l.], v. 153, n. 6, p. 1812–6, 1995. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/7752324 SIEMEISTER, G. et al. Reversion of deregulated expression of vascular endothelial growth factor in human renal carcinoma cells by von Hippel-Lindau tumor suppressor protein. Cancer research, [s. l.], v. 56, n. 10, p. 2299–301, 1996. Disponível em: <http://www.ncbi.nlm.nih.gov/pubmed/8625303> TENOLD, Matthew et al. Current Approaches to the Treatment of Advanced or Metastatic Renal Cell Carcinoma. American Society of Clinical Oncology Educational Book, [S. l.], n. 40, p. 187–196, 2020. VAN DER HORST-SCHRIVERS, Anouk N. A. et al. The incidence of consecutive manifestations in Von Hippel-Lindau disease. Familial Cancer, [S. l.], v. 18, n. 3, p. 369–376, 2019. Disponível em: https://doi.org/10.1007/s10689-019-00131-x VAN POPPEL, Hendrik 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. European Urology, [S. l.], v. 59, n. 4, p. 543–552, 2011. Disponível em: http://dx.doi.org/10.1016/j.eururo.2010.12.013 VARSHNEY, Neha et al. A Review of Von Hippel-Lindau Syndrome. Journal of Kidney Cancer and VHL, [S. l.], v. 4, n. 3, p. 20, 2017. Disponível em: https://jkcvhl.com/index.php/jkcvhl/article/view/88 VON HIPPEL, E. Ueber eine sehr seltene Erkrankung der Nethaut. Graefe Arch. Ophthalmol., [S. l.], v. 106, p. 1904, 1904. WALTHER, McCLELLAN M. et al. RENAL CANCER IN FAMILIES WITH HEREDITARY RENAL CANCER: PROSPECTIVE ANALYSIS OF A TUMOR SIZE THRESHOLD FOR RENAL PARENCHYMAL SPARING SURGERY. Journal of Urology, [S. l.], v. 161, n. 5, p. 1475–1479, 1999. Disponível em: http://www.jurology.com/doi/10.1016/S0022-5347%2805%2968930-6 XU, Congcong et al. Tumor enucleation vs. Partial nephrectomy for T1 renal cell carcinoma: A systematic review and meta-analysis. Frontiers in Oncology, [S. l.], v. 9, n. JUN, p. 1–9, 2019. YOU, Chengyu et al. Laparoscopic Versus Open Partial Nephrectomy: A Systemic Review and Meta-Analysis of Surgical, Oncological, and Functional Outcomes. Frontiers in Oncology, [S. l.], v. 10, n. October, p. 1–11, 2020. ZAORSKY, Nicholas G. et al. Stereotactic ablative radiation therapy for oligometastatic renal cell carcinoma (SABR ORCA): a meta-analysis of 28 studies. European Urology Oncology, [S. l.], v. 2, n. 5, p. 515–523, 2019. Disponível em: https://doi.org/10.1016/j.euo.2019.05.007 ZBAR, Berton et al. Germline mutations in the Von Hippel-Lindau disease (VHL) gene in families from North America, Europe, and Japan. Human Mutation, [S. l.], v. 8, n. 4, p. 348–357, 1996. Disponível em: http://doi.wiley.com/10.1002/%28SICI%291098- 1004%281996%298%3A4%3C348%3A%3AAID-HUMU8%3E3.0.CO%3B2-3info:eu-repo/semantics/openAccessreponame:Repositório do Centro Universitário Braz Cubasinstname:Centro Universitário Braz Cubas (CUB)instacron:CUB2021-02-03T12:36:10Zoai:repositorio.cruzeirodosul.edu.br:123456789/1447Repositório InstitucionalPUBhttps://repositorio.brazcubas.edu.br/oai/requestbibli@brazcubas.edu.bropendoar:2021-02-03T12:36:10Repositório do Centro Universitário Braz Cubas - Centro Universitário Braz Cubas (CUB)false
dc.title.none.fl_str_mv Tratamento cirúrgico de múltiplos renais na síndrome de Von Hippel-Lindau: relato de caso e revisão de literatura
title Tratamento cirúrgico de múltiplos renais na síndrome de Von Hippel-Lindau: relato de caso e revisão de literatura
spellingShingle Tratamento cirúrgico de múltiplos renais na síndrome de Von Hippel-Lindau: relato de caso e revisão de literatura
Ferreira, Marina Guimarães
Doença de von Hippel-Lindau
Câncer renal
Nefrectomia
CNPQ::CIENCIAS DA SAUDE::MEDICINA
title_short Tratamento cirúrgico de múltiplos renais na síndrome de Von Hippel-Lindau: relato de caso e revisão de literatura
title_full Tratamento cirúrgico de múltiplos renais na síndrome de Von Hippel-Lindau: relato de caso e revisão de literatura
title_fullStr Tratamento cirúrgico de múltiplos renais na síndrome de Von Hippel-Lindau: relato de caso e revisão de literatura
title_full_unstemmed Tratamento cirúrgico de múltiplos renais na síndrome de Von Hippel-Lindau: relato de caso e revisão de literatura
title_sort Tratamento cirúrgico de múltiplos renais na síndrome de Von Hippel-Lindau: relato de caso e revisão de literatura
author Ferreira, Marina Guimarães
author_facet Ferreira, Marina Guimarães
author_role author
dc.contributor.none.fl_str_mv Rebouças, Rafael Batista
http://lattes.cnpq.br/4418656802605634
dc.contributor.author.fl_str_mv Ferreira, Marina Guimarães
dc.subject.por.fl_str_mv Doença de von Hippel-Lindau
Câncer renal
Nefrectomia
CNPQ::CIENCIAS DA SAUDE::MEDICINA
topic Doença de von Hippel-Lindau
Câncer renal
Nefrectomia
CNPQ::CIENCIAS DA SAUDE::MEDICINA
description Von Hippel-Lindau disease (VHL) is an autosomal dominant genetic condition associated with mutations in the VHL tumor suppressor gene. The most common clinical presentations are tumors of the central nervous system (CNS), retina, kidney, pancreas, pheochromocytomas and simple cysts in solid organs. Renal involvement is cysts and clear cell renal carcinoma. The diagnosis of the disease is based on well-defined clinical criteria and genetic testing. It was noticed that the number of deaths due to RCC decreased over the period, most likely due to the benefits of regular surveillance protocols and the preservation of renal function, promoted by the change in treatment. The surgical approach went from radical nephrectomy associated with dialysis to nephron-sparing approaches, with emphasis on partial nephrectomy. The present study proposes to report the case of a patient, with von Hippel-Lindau disease, who underwent surgical treatment of multiple kidney tumors. The surgical technique and perioperative results were described. The results were analyzed based on the correlation with the literature review. This is an observational, single-arm, descriptive, case report type study, based on retrospective information obtained from the patient's medical record. Clinical history, laboratory exams, image exams, videos of the surgeries performed, description of the surgical technique and pre, trans and postoperative elements were analyzed. The research was approved by the Research Ethics Committee (CEP) and generated the Presentation Certificate for Ethical Appreciation (CAAE) 30549420.9.0000.5176. The patient, with von HippelLindau syndrome, was forwarding renal tumors in both kidneys, with an R.E.N.A.L. 9x and 10x in the right kidney and 11p in the left kidney. He underwent partial laparoscopic nephrectomies, without peri and postoperative complications. It is monitored under active surveillance through MRI of the abdomen annually Enucleation of tumors, associated with techniques that prevent complete ischemia of the kidney, are the main strategies used in order to preserve parenchyma and minimize kidney damage. The laparoscopic approach is a minimally invasive form that can assist in the treatment of renal nodules, especially in those patients who require multiple surgical resections, giving less surgical morbidity. Active surveillance of the kidneys, based on frequent serial examinations, enables cancer control and prevents metastatic disease. Tumors smaller than 3 centimeters can generally be conservative. Strict monitoring ensures that the appropriate time for surgical treatment is defined.
publishDate 2020
dc.date.none.fl_str_mv 2020-12-21
2021-02-03T12:35:04Z
2021-02-04
2021-02-03T12:35:04Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/bachelorThesis
format bachelorThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://repositorio.cruzeirodosul.edu.br/handle/123456789/1447
url https://repositorio.cruzeirodosul.edu.br/handle/123456789/1447
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv AMIN, Mahul B. et al. (org.). AJCC Cancer Staging Manual. Cham: Springer International Publishing, 2017. E-book. Disponível em: http://www.cancerstaging.org/staging/PDFs/washington-stomach.pdf BRAVI, Carlo Andrea et al. Perioperative Outcomes of Open, Laparoscopic, and Robotic Partial Nephrectomy: A Prospective Multicenter Observational Study (The RECORd 2 Project). European Urology Focus, [S. l.], p. 1–7, 2019. Disponível em: https://doi.org/10.1016/j.euf.2019.10.013 BERG, Jonathan S. et al. Processes and preliminary outputs for identification of actionable genes as incidental findings in genomic sequence data in the Clinical Sequencing Exploratory Research Consortium. Genetics in Medicine, [S. l.], v. 15, n. 11, p. 860–867, 2013. BINDERUP, Marie Louise Mølgaard et al. Von Hippel-Lindau disease (vHL). National clinical guideline for diagnosis and surveillance in Denmark. 3rd edition. Danish medical journal, [S. l.], v. 60, n. 12, p. B4763, 2013. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/24355456 BINDERUP, Marie Louise Mølgaard et al. Survival and causes of death in patients with von Hippel-Lindau disease. Journal of Medical Genetics, [S. l.], v. 54, n. 1, p. 11–18, 2017. Disponível em: http://jmg.bmj.com/lookup/doi/10.1136/jmedgenet-2016- 104058 BRATSLAVSKY, Gennady et al. Salvage Partial Nephrectomy for Hereditary Renal Cancer: Feasibility and Outcomes. Journal of Urology, [S. l.], v. 179, n. 1, p. 67–70, 2008. BRATSLAVSKY, Gennady; LINEHAN, W. Marston. Long-term management of bilateral, multifocal, recurrent renal carcinoma. Nature Reviews Urology, [S. l.], v. 7, n. 5, p. 267–275, 2010. Disponível em: http://dx.doi.org/10.1038/nrurol.2010.44 CACCIAMANI, Giovanni E. et al. Impact of Renal Hilar Control on Outcomes of Robotic Partial Nephrectomy: Systematic Review and Cumulative Meta-analysis. European Urology Focus, [S. l.], v. 5, n. 4, p. 619–635, 2019. CAMPBELL, Steven et al. 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dc.publisher.none.fl_str_mv Centro Universitário de João Pessoa
Brasil
UNIPÊ
publisher.none.fl_str_mv Centro Universitário de João Pessoa
Brasil
UNIPÊ
dc.source.none.fl_str_mv reponame:Repositório do Centro Universitário Braz Cubas
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