PAEA Surgery End Of Rotation (EOR) Practice Exam

If a renal tumor is less than 4 cm, what surgical approach is preferred?

1. Radical nephrectomy

2. Watchful waiting

3. Partial nephrectomy

4. Laparoscopic nephrectomy

The correct answer is: Partial nephrectomy

When dealing with a renal tumor that is less than 4 cm in size, the preferred surgical approach is partial nephrectomy. This technique involves the removal of the tumor along with a margin of healthy tissue while sparing the surrounding kidney. The rationale for selecting partial nephrectomy over a radical nephrectomy, which entails the complete removal of the affected kidney, is primarily to preserve renal function. Preserving as much of the kidney as possible is critical, especially in patients who may have underlying kidney issues or at risk for future renal impairment. Studies have shown that for small renal tumors, partial nephrectomy has comparable cancer control outcomes to radical nephrectomy, especially in carefully selected patients. Moreover, it allows for better preservation of renal function, which is beneficial for the patient's long-term health and quality of life. Watchful waiting may be considered for very small, asymptomatic tumors, but this approach is not generally preferred when a surgical intervention is warranted. Laparoscopic nephrectomy, while minimally invasive, refers to the removal of the entire kidney rather than just the tumor, making it less appropriate in this context compared to partial nephrectomy. Thus, choosing partial nephrectomy aligns with the goal of effectively managing the tumor while