Dong Xiaoyong, Zhang Jie, Pan Yongjun, Xie Tiejun, Wang Jinhua
Department of Urology, The Beibei Affiliated Hospital of Chongqing Medical University, The Ninth People's Hospital of Chongqing, Chongqing, China.
Front Oncol. 2025 Jun 4;15:1484844. doi: 10.3389/fonc.2025.1484844. eCollection 2025.
Indocyanine green (ICG) is a widely utilized non-radiative fluorescent contrast agent that has progressively demonstrated unique advantages in urological endoscopic surgeries in recent years. Despite its potential advantages, to date, no reports have detailed the use of fluorescence laparoscopy in cytoreductive nephrectomy and thrombectomy(CNT) for metastatic renal cell carcinoma (mRCC) complicated by renal vein tumor thrombus. This paper presents a single-case clinical experience of CNT for mRCC with renal vein tumor thrombus, with procedures guided by ICG fluorescence-guided laparoscopy.
We retrospectively analyzed the clinical data of a patient diagnosed with mRCC complicated by renal vein tumor thrombus. The patient underwent CNT at Beibei Hospital, Chongqing Medical University on November 7, 2023.
A 65-year-old male had a left renal tumor, systemic metastases, and left renal vein tumor thrombus shown by preoperative computed tomography(CT). Before surgery, he received seven cycles of anti PD-1 (Toripalimab) immunotherapy and 20 days of pazopanib (anti-vascular TKI), which was stopped due to liver impairment. After treatment, the left renal lesion shrank and some metastases vanished. As the patient was in good condition and willing to have surgery, CNT was done under ICG fluorescence-guided laparoscopy successfully. Post-operative pathology confirmed left kidney clear cell carcinoma with left renal vein tumor thrombus. No complications occurred, and the patient recovered and was discharged. Regular rechecks of 16 months showed no tumor progression.
ICG fluorescence real-time imaging technology is characterized by real-time dynamics, convenience and safety. Performing CNT for mRCC with tumor thrombus in the renal vein under ICG fluorescence navigation laparoscopy is safe and feasible.
吲哚菁绿（ICG）是一种广泛应用的非放射性荧光造影剂，近年来在泌尿外科内镜手术中逐渐显示出独特优势。尽管其具有潜在优势，但迄今为止，尚无报告详细介绍荧光腹腔镜在转移性肾细胞癌（mRCC）合并肾静脉肿瘤血栓的减瘤性肾切除术及血栓切除术（CNT）中的应用。本文介绍了1例mRCC合并肾静脉肿瘤血栓患者在ICG荧光引导腹腔镜引导下进行CNT的单病例临床经验。
我们回顾性分析了1例诊断为mRCC合并肾静脉肿瘤血栓患者的临床资料。该患者于2023年11月7日在重庆医科大学附属北碚医院接受了CNT手术。
一名65岁男性，术前计算机断层扫描（CT）显示左肾肿瘤、全身转移及左肾静脉肿瘤血栓。术前，他接受了7个周期的抗PD - 1（托瑞帕利单抗）免疫治疗和20天的帕唑帕尼（抗血管TKI）治疗，因肝功能损害而停药。治疗后，左肾病变缩小，部分转移灶消失。由于患者身体状况良好且愿意接受手术，遂在ICG荧光引导腹腔镜下成功进行了CNT手术。术后病理证实为左肾透明细胞癌伴左肾静脉肿瘤血栓。未发生并发症，患者康复出院。16个月的定期复查显示无肿瘤进展。
ICG荧光实时成像技术具有实时动态、方便安全的特点。在ICG荧光导航腹腔镜下对mRCC合并肾静脉肿瘤血栓进行CNT手术是安全可行的。
