Fukumoto Ryo, Ohtoshi Taiyo, Kobayashi Ken-ichi, Akihiro Fujita, Imamura Ryoichi, Tsujimoto Yuichi, Arai Yasuyuki, Takada Shingo, Matsumiya Kiyomi, Fujioka Hideki
The Department of Urology, Osaka Police Hospital.
Hinyokika Kiyo. 2009 Oct;55(10):615-8.
A 30-year-old female was referred to our hospital complaining of left flank pain. She was diagnosed with a giant hydronephrosis in a horseshoe kidney. We performed a retroperitoneoscopic nephrectomy on the non-functioning moiety of the horseshoe kidney. After the placement of a ureteral catheter, she underwent a retroperitoneal nephrectomy. The feeding vessels consisted of four arteries and four veins. The thin isthmus of the horseshoe kidney was divided using scissors, without the need for electrocautery, and hemostasis was achieved using monopolar shears. Laparoscopic nephrectomy on a horseshoe kidney is a difficult surgery given the aberrant vessels and isthmus, so it tends to be avoided for reasons of safety. However, if appropriate preoperative imaging is carried out and the procedure is conducted in a careful manner, it can be made a safe and minimally invasive operation.
一名30岁女性因左侧腰痛转诊至我院。她被诊断为马蹄肾合并巨大肾积水。我们对马蹄肾无功能部分进行了后腹腔镜肾切除术。放置输尿管导管后，她接受了后腹腔镜肾切除术。供血血管包括四条动脉和四条静脉。马蹄肾的狭窄峡部用剪刀分离，无需电灼，用单极剪实现止血。鉴于血管异常和峡部情况，马蹄肾的腹腔镜肾切除术是一项困难的手术，因此出于安全考虑往往避免进行。然而，如果术前进行适当的影像学检查并谨慎操作，它可以成为一种安全且微创的手术。
