Ahmadi Abdolsalam, Al Rashed Ahmed A, Ebrahim Sayed H, Hasan Omran, Alaradi Husain, Abdulaziz Khalid, Jalal Akbar, Awad Nader
Urology, Salmaniya Medical Complex, Manama, BHR.
Surgery, Salmaniya Medical Complex, Manama, BHR.
Cureus. 2022 Jul 16;14(7):e26928. doi: 10.7759/cureus.26928. eCollection 2022 Jul.
An ectopic kidney is a rare developmental anomaly in which the kidney can be pelvic, iliac, abdominal, and thoracic, and affected patients are more prone to conditions such as reflux, pelvic ureteric junction (PUJ) obstruction, hydronephrosis, nephrolithiasis, and even renal failure than patients with normally structured kidneys. In this case, we present a 43-year-old male who is a known case of ectopic left pelvic kidney and presented with chronic lower abdominal pain. Upon imaging, it was revealed that he had a staghorn stone for which he underwent laparoscopy-assisted percutaneous nephrolithotripsy (PCNL). Postoperatively, the patient underwent a quick recovery and was discharged on postoperative day 3 without any perioperative complications. Hence given our experience with this case and the similar experiences of urologists over time, the use of laparoscopy-assisted PCNL appears to create a safe way of entering the abdomen and locating the ectopic kidney as well as provide visual guidance in puncture and dilatation all the while protecting the adjacent structures from harm. This demonstrates that laparoscopy-assisted PCNL is a feasible safe and minimally invasive procedure for patients with ectopic kidneys presenting with large stones.
异位肾是一种罕见的发育异常，肾脏可位于盆腔、髂窝、腹部和胸腔，与肾脏结构正常的患者相比，受影响的患者更容易出现诸如反流、肾盂输尿管连接处（PUJ）梗阻、肾积水、肾结石，甚至肾衰竭等病症。在本病例中，我们介绍一位43岁男性，他是已知的左盆腔异位肾患者，表现为慢性下腹痛。经影像学检查，发现他有鹿角形结石，为此他接受了腹腔镜辅助经皮肾镜取石术（PCNL）。术后，患者恢复迅速，术后第3天出院，无任何围手术期并发症。因此，鉴于我们对该病例的经验以及泌尿外科医生长期以来的类似经验，腹腔镜辅助PCNL似乎提供了一种安全进入腹部和定位异位肾的方法，同时在穿刺和扩张过程中提供视觉引导，同时保护相邻结构免受伤害。这表明腹腔镜辅助PCNL对于患有大结石的异位肾患者是一种可行、安全且微创的手术。
