Sausville Justin, Chason Judd, Phelan Michael
Department of Surgery, University of Maryland Medical Center, Baltimore, USA.
JSLS. 2009 Jul-Sep;13(3):462-4.
Horseshoe kidney is a relatively common renal fusion anomaly. There are increasing reports of successful laparoscopic management of surgical disease in this entity. Xanthogranulomatous pyelonephritis (XGP) is an inflammatory condition of chronically obstructed and infected kidneys that is typically refractory to medical management. XGP has been regarded as a contraindication to laparoscopic surgery. Successful laparoscopic nephrectomies have been reported, albeit with high conversion and complication rates. In this report, we describe successful laparoscopic heminephrectomy for a horseshoe kidney moiety that was subsequently shown to have pathologic features of XGP.
We report the case of a woman who underwent laparoscopic heminephrectomy for XGP of a horseshoe kidney. We discuss surgical technique and patient outcome. We also performed and report on a focused review of the relevant literature.
Pure laparoscopic heminephrectomy was completed by a transperitoneal approach. The patient was discharged the day after surgery.
Laparoscopy is a viable approach for the management of XGP in horseshoe kidneys. However, this is a challenging procedure that should be the domain of advanced laparoscopic surgeons.
马蹄肾是一种相对常见的肾脏融合异常。关于该疾病中外科疾病的腹腔镜治疗成功的报道日益增多。黄色肉芽肿性肾盂肾炎（XGP）是一种慢性梗阻和感染肾脏的炎症性疾病，通常对药物治疗无效。XGP一直被视为腹腔镜手术的禁忌证。尽管有高转换率和并发症发生率，但已有成功的腹腔镜肾切除术的报道。在本报告中，我们描述了一例马蹄肾部分成功的腹腔镜半肾切除术，随后发现该部分具有XGP的病理特征。
我们报告了一例因马蹄肾XGP接受腹腔镜半肾切除术的女性病例。我们讨论了手术技术和患者预后。我们还进行并报告了对相关文献的重点回顾。
通过经腹途径完成了单纯腹腔镜半肾切除术。患者术后次日出院。
腹腔镜检查是治疗马蹄肾XGP的一种可行方法。然而，这是一个具有挑战性的手术，应由高级腹腔镜外科医生进行。
