Kochkin A D, Gallyamov E A, Medvedev V L, Popov S V, Biktimirov R G, Sevryukov F A, Sergeev V P, Orlov I N
) PRMU of Minzdrav of Russia, Nizhny Novgorod, Russia.
) Clinical Hospital at Nizhny Novgorod Railway Station of JSC RZD, Nizhny Novgorod, Russia.
Urologiia. 2019 Jun(2):36-39.
Although horseshoe kidney (HSK) is the most common congenital anomaly of the upper urinary tract, renal cell cancer (RCC) in HSK develops extremely rarely. Until 2012 y. there were less than 200 cases of RCC in HSK published in PubMed. Only five cases of laparoscopic partial nephrectomies and some cases of heminephrectomies have been described in PubMed.
To conduct a multicenter retrospective analysis of laparoscopic surgery for tumors in HSK.
From January 2013 to December 2018 a total of 19 conventional laparoscopic interventions were performed in patients with RCC in HSK, including 1 isthmusectomy, 5 partial nephrectomies and 13 heminefrectomies. In addition, 16 divisions of isthmus were done in 15 patients. The video describing our operation technique is available on: http://youtu.be/nk-WlbjNtIs .
There were no conversions to open surgery and mortality as well as intra- and postoperative complications of Clavien grade 3 or higher. Warm ischemia time during partial nephrectomy didnt exceed 19 minutes. Operative time ranged from 110 to 270 min, while max estimated blood loss was 400 ml. All patients were followed for 6 month and no case of disease recurrence or progression was noted.
The small number of laparoscopic interventions in patients with RCC in HSK doesnt allow to carry out a proper statistical analysis and draw certain conclusions. We presented the largest experience available in the literature and our results demonstrate the efficacy and safety of conventional laparoscopic technologies in the treatment of RCC in HSK.
虽然马蹄肾（HSK）是上尿路最常见的先天性异常，但HSK中发生肾细胞癌（RCC）极为罕见。截至2012年，PubMed上发表的HSK中RCC病例不到200例。PubMed中仅描述了5例腹腔镜部分肾切除术和一些半肾切除术病例。
对HSK肿瘤的腹腔镜手术进行多中心回顾性分析。
2013年1月至2018年12月，共对HSK合并RCC患者进行了19例传统腹腔镜手术，包括1例峡部切除术、5例部分肾切除术和13例半肾切除术。此外，对15例患者进行了16次峡部分离。描述我们手术技术的视频可在以下网址观看：http://youtu.be/nk-WlbjNtIs 。
无转为开放手术情况，无死亡病例，也无Clavien 3级或更高等级的术中及术后并发症。部分肾切除术期间的热缺血时间不超过19分钟。手术时间为110至270分钟，最大估计失血量为400毫升。所有患者均随访6个月，未发现疾病复发或进展病例。
HSK合并RCC患者的腹腔镜手术例数较少，无法进行适当的统计分析并得出确切结论。我们展示了文献中现有的最大经验，我们的结果证明了传统腹腔镜技术在治疗HSK中RCC方面的有效性和安全性。
