Imai Yu, Urabe Fumihiko, Fukuokaya Wataru, Matsukawa Akihiro, Iwatani Kosuke, Aikawa Koichi, Obayashi Koki, Yanagisawa Takafumi, Tsuzuki Shunsuke, Nakajo Hiroshi, Kimura Takahiro, Egawa Shin, Miki Jun
Department of Urology The Jikei University School of Medicine, Kashiwa Hospital Kashiwa Chiba.
Department of Urology The Jikei University School of Medicine Tokyo Japan.
IJU Case Rep. 2022 Apr 26;5(4):259-262. doi: 10.1002/iju5.12450. eCollection 2022 Jul.
Owing to the complexity of their blood supply, renal tumors in horseshoe kidneys are sometimes technically challenging to resect through laparoscopic procedures.
A 75-year-old man presented with a 3-cm lower-pole mass in the right moiety of the horseshoe kidney. Indocyanine green administration allowed for the identification of the tumor's feeding artery, which was selectively clamped to perform laparoscopic partial nephrectomy. During the procedure, the patient was positioned in the modified supine position (30° semi-lateral position), which enabled us to approach the branch of the left renal artery. Postoperative pathologic examination of the resected mass confirmed the diagnosis of pT1a clear cell renal cell carcinoma with negative surgical margins.
Our novel laparoscopic approach with indocyanine green fluorescence in the modified supine position facilitates the identification of and access to the tumor's feeding artery. This technique is advantageous for laparoscopic partial nephrectomy in patients with horseshoe kidney.
由于马蹄肾血液供应的复杂性，通过腹腔镜手术切除马蹄肾中的肾肿瘤有时在技术上具有挑战性。
一名75岁男性，马蹄肾右侧部分下极有一个3厘米的肿块。注射吲哚菁绿后可识别肿瘤的供血动脉，对其进行选择性夹闭以实施腹腔镜部分肾切除术。手术过程中，患者采用改良仰卧位（30°半侧卧位），这使我们能够接近左肾动脉分支。切除肿块的术后病理检查确诊为pT1a期透明细胞肾细胞癌，手术切缘阴性。
我们在改良仰卧位采用吲哚菁绿荧光的新型腹腔镜手术方法有助于识别和接近肿瘤的供血动脉。该技术对马蹄肾患者的腹腔镜部分肾切除术具有优势。
