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病例报告:远端高危上尿路尿路上皮癌患者完全腹腔镜下自体肾移植的分步手术过程

Case Report: Step-by-step procedures for total intracorporeal laparoscopic kidney autotransplantation in a patient with distal high-risk upper tract urothelial carcinoma.

作者信息

Wu Guohao, Li Haomin, Li Junqiang, Chen Mubiao, Xie Lishan, Luo Huilan, Chen Zhihui, Ye Dongming, Lai Caiyong

机构信息

Department of Urology, Sixth Affiliated Hospital of Jinan University, Dongguan, China.

Department of Urology, First Affiliated Hospital of Jinan University, Guangzhou, China.

出版信息

Front Oncol. 2023 Apr 24;13:1142819. doi: 10.3389/fonc.2023.1142819. eCollection 2023.

Abstract

A 47-year-old man presented to the emergency department with right abdominal pain and a new onset of painless haematuria two weeks earlier. Urine cytology test results suggested urothelial carcinoma. Computed tomography urography (CTU) showed a filling defect in the lower right ureter with right hydronephrosis. Lymphadenopathy and any signs of metastatic disease were absent on CTU. Cystoscopy appeared normal. Creatinine level was also normal before surgery. After the treatment options were discussed, the patient chose to undergo 3D total intracorporeal laparoscopic kidney autotransplantation, bladder cuff excision, and segmental resection of the proximal two-thirds of the ureter based on the membrane anatomy concept. After more than one year of follow-up, the patient was in good health and showed no signs of haematuria. Surveillance cystoscopy and CTU examination showed no evidence of disease recurrence. Therefore, it is reasonable to assume that kidney-sparing surgery may be considered for carefully selected patients with high-grade upper tract urothelial carcinoma.

摘要

一名47岁男性因右腹疼痛于两周前出现无痛性血尿而就诊于急诊科。尿液细胞学检查结果提示尿路上皮癌。计算机断层扫描尿路造影(CTU)显示右输尿管下段充盈缺损伴右肾积水。CTU未发现淋巴结肿大及任何转移疾病迹象。膀胱镜检查未见异常。术前肌酐水平也正常。在讨论了治疗方案后,患者选择基于膜解剖学概念接受3D全腹腔镜自体肾移植、膀胱袖口切除术以及输尿管近端三分之二节段性切除术。经过一年多的随访,患者身体健康,无血尿迹象。监测膀胱镜检查和CTU检查未发现疾病复发迹象。因此,对于精心挑选的高级别上尿路尿路上皮癌患者,考虑保留肾手术是合理的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4ef/10164996/0c67db12479d/fonc-13-1142819-g001.jpg

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