Martínez Bengoechea J J, Liédana Torres J M, Gil Sanz M J, Urruchi Fernández P, Rioja Sanz L A
Servicio de Urología, Hospital Miguel Servet, Zaragoza, España.
Arch Esp Urol. 1991 Jul-Aug;44(6):683-9.
Conservative surgery is considered to be the treatment of choice in patients with bilateral renal tumors or tumor in the solitary kidney owing to the need to preserve renal function. A case of a 63-year-old patient with bilateral renal carcinoma is described. The presenting symptoms were pain and paraneoplastic signs. The patient did not present hematuria throughout the course of the disease. The urographic, ultrasound and tomodensitometric work up correctly determined tumor size, characteristics and anatomic relationship. Arteriography permitted mapping of the vascular structures of both kidneys. Fine needle aspiration biopsy permitted histologic classification preoperatively. The approach was via a Chevron incision. An extended nephrectomy was performed on the left kidney and surgical enucleation of the tumor in the right kidney in a one stage procedure. The diagnostic aspects are discussed and the therapeutic options are reviewed with special reference to the conservative procedures.
由于需要保留肾功能，对于双侧肾肿瘤或孤立肾肿瘤患者，保守手术被认为是首选治疗方法。本文描述了一例63岁双侧肾癌患者的病例。患者的主要症状为疼痛和副肿瘤综合征体征。在整个疾病过程中患者未出现血尿。尿路造影、超声和计算机断层扫描检查正确地确定了肿瘤大小、特征及解剖关系。动脉造影可显示双肾的血管结构。细针穿刺活检可在术前进行组织学分类。手术入路采用人字形切口。一期手术切除了左肾并对右肾肿瘤进行了剜除术。文中讨论了诊断方面的问题，并特别参考保守手术方法对治疗选择进行了综述。
