Minami Keita, Harada Hiroshi, Sasaki Hajime, Higuchi Haruka, Tanaka Hiroshi
Department of Kidney Transplant Surgery and Urology, Sapporo City General Hospital, Sapporo, Japan.
J Endourol Case Rep. 2020 Dec 29;6(4):540-543. doi: 10.1089/cren.2020.0146. eCollection 2020.
Radical prostatectomy for prostate cancer (PCa) among kidney transplant (KT) recipients (KTRs) can be challenging because of the location of the renal allograft, which may make robot-assisted radical prostatectomy (RARP) difficult to perform. In this study, we present the first case of RARP in a patient with two renal allografts in both iliac fossae. A 72-year-old KTR was found to have organ-confined PCa. He had a first KT (in the right iliac fossa) 20 years ago, which he lost because of chronic allograft nephropathy, followed by a second KT (in the left iliac fossa) 8 years ago, which is now functioning well. We performed RARP with a right-nerve sparing technique. The surgical duration was 208 minutes, with an estimated blood loss of 50 mL and no intraoperative complications. The postoperative course was unremarkable. During the 21-month follow-up period, there was no incontinence or biochemical recurrence and the allograft function remained normal. RARP is feasible and can be performed safely in KT patients with two renal allografts in the pelvis.
对于肾移植（KT）受者（KTRs）中的前列腺癌（PCa）患者，根治性前列腺切除术可能具有挑战性，因为同种异体肾移植物的位置可能会使机器人辅助根治性前列腺切除术（RARP）难以实施。在本研究中，我们报告了首例双侧髂窝均有两个同种异体肾移植物的患者接受RARP的病例。一名72岁的KTR被发现患有器官局限性PCa。他20年前首次接受KT（右髂窝），后因慢性同种异体肾病失去该移植物，8年前再次接受KT（左髂窝），目前该移植物功能良好。我们采用保留右侧神经的技术进行了RARP。手术时间为208分钟，估计失血量为50毫升，无术中并发症。术后过程顺利。在21个月的随访期内，无尿失禁或生化复发，同种异体肾移植物功能保持正常。RARP在盆腔内有两个同种异体肾移植物的KT患者中是可行的，并且可以安全实施。
