Fujihara Atsuko, Hongo Fumiya, Narukawa Tsukasa, Nomura Takeshi, Yamada Yasuhiro, Ukimura Osamu
Department of Urology Kyoto Prefectural University of Medicine Kyoto Japan.
IJU Case Rep. 2019 Jul 23;2(6):308-311. doi: 10.1002/iju5.12108. eCollection 2019 Nov.
Horseshoe kidney has unique anatomical features, such as a complex blood supply. We report a patient with renal cell carcinoma in a horseshoe kidney, who underwent tumor resection by robot-assisted laparoscopic partial nephrectomy based on preoperative three-dimensional computed tomography.
A 66-year-old man was referred to our hospital with a 2-cm enhancing mid-pole mass in the left moiety of a horseshoe kidney. The clinical diagnosis was renal cell carcinoma cT1aN0M0 (R.E.N.A.L. nephrometry score: 1 + 2 + 3 + 3 = 9p). Robot-assisted laparoscopic partial nephrectomy was performed with selective clamping based on reconstructed three-dimensional images. The warm ischemia time was 13 min. Pathologic examination confirmed a diagnosis of pT1a clear cell renal cell carcinoma with negative surgical margins. At 6 months postoperatively, computed tomography showed no local recurrence or metastasis and renal function was intact.
Robot-assisted laparoscopic partial nephrectomy with preoperative three-dimensional computed tomography may have advantages for resection of tumors in patients with horseshoe kidney.
马蹄肾具有独特的解剖学特征，如复杂的血液供应。我们报告一例马蹄肾合并肾细胞癌患者，该患者在术前三维计算机断层扫描的基础上，接受了机器人辅助腹腔镜肾部分切除术。
一名66岁男性因马蹄肾左半部分中极有一个2厘米的强化肿块而转诊至我院。临床诊断为肾细胞癌cT1aN0M0（R.E.N.A.L.肾计量评分：1 + 2 + 3 + 3 = 9分）。基于重建的三维图像进行选择性钳夹，实施了机器人辅助腹腔镜肾部分切除术。热缺血时间为13分钟。病理检查确诊为pT1a期透明细胞肾细胞癌，手术切缘阴性。术后6个月，计算机断层扫描显示无局部复发或转移，肾功能完好。
术前三维计算机断层扫描辅助下的机器人腹腔镜肾部分切除术对于马蹄肾患者的肿瘤切除可能具有优势。
