Luo Shu-Hang, Zeng Qin-Song, Chen Jun-Xing, Huang Bin, Wang Zong-Ren, Li Wen-Ji, Yang Yun, Chen Ling-Wu
Department of Urology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
Department of Anesthesiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
World J Clin Cases. 2022 Apr 26;10(12):3886-3892. doi: 10.12998/wjcc.v10.i12.3886.
Giant renal angiomyolipomas (AMLs) may lead to complications including flank pain, hematuria, hypertension, retroperitoneal hemorrhage and even death. Giant AMLs which grow around renal hilar vessels and the ureter are rare. Most previous reports on the treatment of giant renal AMLs have focused on open surgery or a transperitoneal approach, with few studies on the retroperitoneal approach for large AMLs. We here report a case of giant renal hilum AML successfully treated with robot-assisted laparoscopic nephron sparing surgery the retroperitoneal approach, with a one-year follow-up.
A 34-year-old female patient was diagnosed with renal AML 11 years ago and showed no discomfort. The tumor gradually increased in size to a giant AML over the years, which measured 63 mm × 47 mm ×90 mm and was wrapped around the right hilum. Therefore, a robotic laparoscopic partial nephrectomy (LPN) the retroperitoneal approach was performed. The patient had no serious postoperative complications and was discharged soon after the operation. At the one-year follow-up, the patient's right kidney had recovered well.
Despite insufficient operating space the retroperitoneal approach, LPN for giant central renal AMLs can be completed using a well-designed procedure with the assistance of a robotic system.
巨大肾血管平滑肌脂肪瘤(AML)可导致包括胁腹痛、血尿、高血压、腹膜后出血甚至死亡等并发症。生长于肾门血管和输尿管周围的巨大AML较为罕见。既往大多数关于巨大肾AML治疗的报道主要集中在开放手术或经腹腔途径,而关于巨大AML经腹膜后途径治疗的研究较少。我们在此报告1例经腹膜后途径机器人辅助腹腔镜保留肾单位手术成功治疗的巨大肾门AML病例,并进行了为期1年的随访。
一名34岁女性患者11年前被诊断为肾AML,当时无不适症状。多年来肿瘤逐渐增大成为巨大AML,大小为63 mm×47 mm×90 mm,包绕右肾门。因此,行经腹膜后途径机器人辅助腹腔镜部分肾切除术(LPN)。患者术后无严重并发症,术后不久即出院。在1年的随访中,患者右肾恢复良好。
尽管经腹膜后途径手术空间有限,但对于巨大中央型肾AML,借助机器人系统,通过精心设计的手术步骤可以完成LPN。