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犬单孔腹腔镜下囊性肾腺瘤去顶及大网膜化术

Single-Incision Laparoscopic Deroofing and Omentalization of a Cystic Renal Adenoma in a Dog.

机构信息

From the College of Veterinary Medicine (N.J.P.) and Department of Clinical Sciences (V.F.S.), North Carolina State University, Raleigh, North Carolina; and Department of Surgical and Radiological Sciences, University of California Davis, Davis, California (R.B.).

出版信息

J Am Anim Hosp Assoc. 2020 Nov 1;56(6):331. doi: 10.5326/JAAHA-MS-6991.

Abstract

A 12 yr old 13.5 kg male castrated Pembroke Welsh corgi was presented for evaluation of a suspected renal cyst following multiple episodes of lethargy and abdominal pain. Abdominal imaging revealed a large, thin-walled, hypoechoic cystic lesion associated with the cranial pole of the left kidney and a second smaller cystic lesion on the caudal pole. The larger cystic lesion was repeatedly drained percutaneously, but the lesion returned to initial size and clinical signs returned within weeks. Percutaneous ethanol sclerotherapy achieved only transient improvement in lesion size and abdominal discomfort. Laparoscopic deroofing and omentalization of the larger left renal cystic lesion was performed. The resected cystic wall was histopathologically consistent with a renal adenoma. Abdominal ultrasonography performed 1 mo postoperatively found no recurrence of the cystic renal adenoma. Repeated ultrasonography at 3 mo postoperatively detected a small cystic lesion at the cranial pole of the left kidney, which remained static in appearance at 11 and 18 mo postoperatively. During all follow-up visits, the dog was reported to be doing well with no recurrence of clinical signs. Renal cysts causing clinical signs and renal adenomas are rare in veterinary medicine; laparoscopic deroofing and omentalization provides a minimally invasive treatment approach.

摘要

一只 12 岁、13.5 公斤重的雄性去势彭布罗克威尔士柯基犬,因多次嗜睡和腹痛,被怀疑患有肾囊肿而就诊。腹部影像学检查显示左肾头部有一个大的薄壁低回声囊性病变,还有第二个较小的囊性病变位于尾部。该较大的囊性病变经皮反复引流,但病变恢复到初始大小,且数周内临床症状再次出现。经皮乙醇硬化疗法仅短暂改善了病变大小和腹部不适。行腹腔镜去顶和大的左肾囊性病变网膜化术。切除的囊性壁组织病理学检查与肾腺瘤一致。术后 1 个月行腹部超声检查,未发现囊性肾腺瘤复发。术后 3 个月行重复超声检查,发现左肾头部有一个小的囊性病变,术后 11 个月和 18 个月时外观保持稳定。在所有随访中,该犬被报道状态良好,无临床症状复发。引起临床症状的肾脏囊肿和肾腺瘤在兽医中较为罕见;腹腔镜去顶和网膜化术提供了一种微创治疗方法。

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