Chikazawa M, Ashida S, Inoue Y, Inoue K, Komatsu F, Shuin T
Department of Urology, Kubokawa Hospital.
Hinyokika Kiyo. 2001 Jan;47(1):31-4.
A 69-year-old man was referred to our department for a cystic tumor, 4.0 cm in diameter, in the lower portion of the right kidney, which was detected by computed tomography. The patient had been admitted to the department of surgery in our hospital for treatment of ileus caused by transverse colon cancer. With a diagnosis of cystic renal cell carcinoma. T2N0M0, in situ non-ischemic tumor enucleation was performed using a microwave tissue coagulator (Microtaze, Heiwa Electronics Industry Inc., Tokyo). The enucleation was accompanied by a defect of the renal pelvis, but it was easily repaired. The operation time was 120 minutes and blood loss was 110 cc. The histological diagnosis was renal cell carcinoma, pT2N0M0V1, expansive, alveolar type, clear cell subtype, G1 > G2. Diagnostic imaging done postoperatively showed no sign of damage to renal function. At the present time, the patient has been disease-free with interferon-alpha for 12 months and is being followed on an outpatient basis. In this report, the advantages of nephron-sparing surgery, especially in situ non-ischemic tumor enucleation using a microwave tissue coagulator for renal tumor are discussed. In particular, the technique of performing tumor enucleation with repair of the defect of renal pelvis used in this case may extend the indication of nephron-sparing surgery.
一名69岁男性因右肾下部一个直径4.0厘米的囊性肿瘤被转诊至我科，该肿瘤由计算机断层扫描检测到。患者曾因横结肠癌导致的肠梗阻入住我院外科接受治疗。诊断为囊性肾细胞癌，T2N0M0，采用微波组织凝固器（Microtaze，黑瓦电子工业公司，东京）进行原位非缺血性肿瘤剜除术。剜除术伴有肾盂缺损，但很容易修复。手术时间为120分钟，失血量为110毫升。组织学诊断为肾细胞癌，pT2N0M0V1，膨胀性，肺泡型，透明细胞亚型，G1>G2。术后的诊断性影像学检查未显示肾功能受损迹象。目前，患者使用α干扰素已无病生存12个月，正在门诊随访。在本报告中，讨论了保留肾单位手术的优点，特别是使用微波组织凝固器对肾肿瘤进行原位非缺血性肿瘤剜除术的优点。特别是，本病例中采用的伴有肾盂缺损修复的肿瘤剜除技术可能会扩大保留肾单位手术的适应证。
