Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
Transplant Proc. 2021 Jun;53(5):1445-1449. doi: 10.1016/j.transproceed.2021.03.033. Epub 2021 May 4.
Nephron-sparing surgery is required for patients with kidney transplant with organ-confined renal cell carcinoma (RCC) in the allograft kidney to preserve renal function. Robot-assisted laparoscopic partial nephrectomy (RAPN) is expected to be the optimal surgical approach for these patients, as in the general population. However, RAPN for RCC arising in the allograft kidney is rarely reported. Here, we report 2 cases of patients who underwent RAPN for allograft RCC.
Two patients were diagnosed with RCC in the renal allograft based on enhanced computed tomography findings. Case 1 was a 69-year-old man with a 32-mm mass in the middle portion of the right iliac fossa renal allograft, and case 2 was a 55-year-old man with a 24-mm mass in the lower pole of the right iliac fossa renal allograft. In each patient, RAPN was performed for the renal mass through a transperitoneal approach, with clamping of the renal artery. No major perioperative complications occurred in either patient, negative surgical margins were achieved, and no significant changes in kidney function were observed during either surgery. Pathologic findings showed clear cell RCC in case 1 and papillary RCC in case 2.
RAPN can be a feasible and effective treatment option for allograft RCC.
为了保留移植肾的肾功能,对于移植肾中存在器官局限性肾细胞癌(RCC)的肾移植患者,需要进行保肾手术。机器人辅助腹腔镜部分肾切除术(RAPN)有望成为这些患者的最佳手术方法,就像在普通人群中一样。然而,很少有关于移植肾 RCC 的 RAPN 报道。在此,我们报告了 2 例接受 RAPN 治疗移植肾 RCC 的患者。
两名患者均根据增强 CT 结果诊断为移植肾 RCC。病例 1 为 69 岁男性,右髂窝移植肾中部有 32mm 大小的肿块;病例 2 为 55 岁男性,右髂窝移植肾下极有 24mm 大小的肿块。在每位患者中,均通过经腹腔途径和肾动脉夹闭来进行 RAPN 切除肾肿瘤。两名患者均未发生重大围手术期并发症,均获得了阴性切缘,并且在手术过程中均未观察到肾功能的显著变化。病理检查显示病例 1 为透明细胞 RCC,病例 2 为乳头状 RCC。
RAPN 可能是治疗移植肾 RCC 的一种可行且有效的治疗选择。