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腹膜后腹腔镜下左肾上盏癌肾部分切除术并节段性肾动脉阻断:一例报告

Retroperitoneal laparoscopic partial nephrectomy with segmental renal artery clamping for cancer of the left upper calyx: a case report.

作者信息

Yu Yajie, Liang Chao, Bao Meiling, Shao Pengfei, Wang Zengjun

机构信息

Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.

Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.

出版信息

BMC Urol. 2017 Aug 31;17(1):73. doi: 10.1186/s12894-017-0264-9.

Abstract

BACKGROUND

Currently, the standard treatment for renal pelvis carcinoma is radical nephroureterectomy with bladder cuff excision. To describe the feasibility of retroperitoneal laparoscopic partial nephrectomy with segmental renal artery clamping for cancer of renal pelvis, we report this special case for the first time.

CASE PRESENTATION

A 67-year-old woman received this operation. Preoperative ureteroscopy revealed a papillary neoplasm with a pedicle in the upper calyx of the left kidney. After entering the retroperitoneal space and dissociating the renal artery and renal vein, the target artery was clamped beyond the final bifurcation before entering the parenchyma. After incision of the left renal parenchyma and exposure of the upper calyceal neck, the tumor was found confined to the upper calyx. Thereafter, the renal calyx and parenchyma were sutured successively after complete resection of the neoplasm. Postoperative pathological examination confirmed that the Grade I papillary carcinoma was confined to the mucosal layer. Thus far, there is no evidence of recurrence during the follow-up period for more than 42 months after surgery.

CONCLUSIONS

Retroperitoneal laparoscopic partial nephrectomy with segmental renal artery clamping of the kidney provides a feasible treatment modality for noninvasive tumors that are limited to the calyx.

摘要

背景

目前,肾盂癌的标准治疗方法是根治性肾输尿管切除术并切除膀胱袖口组织。为描述经腹膜后腹腔镜肾部分切除术并分段肾动脉阻断术治疗肾盂癌的可行性,我们首次报道此特殊病例。

病例介绍

一名67岁女性接受了该手术。术前输尿管镜检查发现左肾上极有一个带蒂的乳头状肿瘤。进入腹膜后间隙并游离肾动脉和肾静脉后,在目标动脉进入实质前的最后一级分支远端进行阻断。切开左肾实质并暴露上肾盏颈部后,发现肿瘤局限于上肾盏。随后,在肿瘤完全切除后依次缝合肾盏和实质。术后病理检查证实为Ⅰ级乳头状癌,局限于黏膜层。截至目前,术后随访42个月以上无复发迹象。

结论

经腹膜后腹腔镜肾部分切除术并分段肾动脉阻断术为局限于肾盏的非侵袭性肿瘤提供了一种可行的治疗方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2f2/5580297/8a91b93f6ae4/12894_2017_264_Fig1_HTML.jpg

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