Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Science, Beijing, China.
Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
BMC Nephrol. 2021 Apr 9;22(1):127. doi: 10.1186/s12882-021-02318-w.
Renal tumors during pregnancy are rare and the treatment requires evaluation of both the patient and the fetus. No consensus or guidelines has been proposed or verified in this field. We successfully managed three renal tumor cases during pregnancy and reviewed the relative literature.
In the first renal cell carcinoma case diagnosed in the 21st week of pregnancy, laparoscopic retroperitoneoscopic partial nephrectomy was performed in the 26th week of pregnancy. In the second renal cell carcinoma case diagnosed in the 3rd week of pregnancy, laparoscopic retroperitoneoscopic radical nephrectomy was carried out after the abortion. In the third angiomyolipoma case who was diagnosed before pregnancy but received no treatment, we performed laparoscopic retroperitoneoscopic partial nephrectomy during the 17th week of pregnancy due to the rapid enlargement of the tumor.
Although no consensus or guidelines for the management of renal tumors in pregnant patients has been proposed or verified, the general rules of kidney tumor management in non-pregnant patients and the guidelines for surgery in pregnancy could be referred to. Renal tumors found in pregnant patients require an individualized treatment regimen involving surgical timing, routes, techniques, and excision ranges, which should be decided by both the patients and the surgical teams.
妊娠期间的肾脏肿瘤较为罕见，其治疗需要同时评估患者和胎儿的情况。目前在该领域尚未提出或验证任何共识或指南。我们成功管理了 3 例妊娠期间的肾脏肿瘤病例，并复习了相关文献。
在妊娠 21 周诊断出的首例肾细胞癌病例中，我们在妊娠 26 周时进行了腹腔镜后腹腔镜肾部分切除术。在妊娠第 3 周诊断出的第 2 例肾细胞癌病例中，在流产后进行了腹腔镜后腹腔镜根治性肾切除术。在第 3 例血管平滑肌脂肪瘤病例中，该病例在妊娠前诊断出但未进行治疗，由于肿瘤迅速增大，我们在妊娠第 17 周时进行了腹腔镜后腹腔镜肾部分切除术。
虽然尚未提出或验证针对妊娠患者肾脏肿瘤处理的共识或指南，但可以参考非妊娠患者的肾脏肿瘤处理一般原则和妊娠手术指南。对于妊娠期间发现的肾脏肿瘤，需要制定个体化的治疗方案，包括手术时机、途径、技术和切除范围，应由患者和手术团队共同决定。
