Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Asian J Endosc Surg. 2021 Jan;14(1):57-62. doi: 10.1111/ases.12831. Epub 2020 Jun 29.
Bilateral renal tumors accounts for approximately 3% of renal tumors. However, surgical treatment methods for bilateral renal tumors have not yet been established. It is imperative to balance the need for curative surgery with the goal of maximal functional preservation in patients with bilateral synchronous renal tumors. Therefore, partial nephrectomy may be the optimal surgical treatment for bilateral synchronous renal tumors.
We conducted a retrospective, observational study to analyze the clinical outcome of simultaneous robotic-assisted partial nephrectomy (RAPN) for bilateral renal tumors at our institution between 2016 and 2019. A total of eight patients were enrolled and the number of renal masses in the 16 kidneys was 18.
There was no positive surgical margin after RAPN in our case series and no local recurrence or metastasis during the follow-up period. The only complication of simultaneous RAPN in the present case series was that one patient experienced acute kidney injury after operation without need for dialysis therapy.
Our study suggests that simultaneous RAPN for bilateral renal tumors might be feasible both for the preservation of renal function and for oncological outcome such as negative surgical margin.
双侧肾脏肿瘤约占肾脏肿瘤的 3%。然而，双侧肾脏肿瘤的手术治疗方法尚未确定。在双侧同时性肾脏肿瘤患者中，平衡根治性手术的需求与最大限度保留肾功能的目标至关重要。因此，部分肾切除术可能是双侧同时性肾脏肿瘤的最佳手术治疗方法。
我们进行了一项回顾性观察研究，分析了 2016 年至 2019 年间我院同期行机器人辅助部分肾切除术（RAPN）治疗双侧肾脏肿瘤的临床疗效。共纳入 8 例患者，16 个肾脏的肾肿瘤数量为 18 个。
在我们的病例系列中，RAPN 后无肿瘤切缘阳性，随访期间无局部复发或转移。本病例系列中同期 RAPN 的唯一并发症是 1 例患者术后发生急性肾损伤，无需透析治疗。
我们的研究表明，同期 RAPN 治疗双侧肾脏肿瘤既能保留肾功能，又能获得阴性手术切缘等肿瘤学结果。
