Ohzeki Takayuki, Mitsuhashi Yuto, Ohta Yoshio, Fujimoto Saizo, Fujita Kazutoshi
Department of Urology, Izumi City General Hospital, Izumi, JPN.
Department of Diagnostic Pathology, Izumi City General Hospital, Izumi, JPN.
Cureus. 2025 Aug 6;17(8):e89506. doi: 10.7759/cureus.89506. eCollection 2025 Aug.
The horseshoe kidney is the most common renal fusion anomaly, and its unique anatomical configuration and aberrant vasculature present significant surgical challenges, particularly in malignant conditions such as urothelial carcinoma. We report a case of robot-assisted right nephroureterectomy with the da Vinci Xi® Surgical System (Intuitive Surgical Inc., Sunnyvale, CA) in a patient with right lower ureteral cancer associated with a horseshoe kidney. The procedure was completed robotically using the da Vinci Xi® system in 207 minutes with minimal blood loss. The pathological diagnosis was high-grade urothelial carcinoma (pT2) with negative surgical margins and one positive lymph node near the ureteral tumor (N1). The postoperative course was uneventful, and no recurrence was observed at 24 months. This case demonstrates the safety and efficacy of robot-assisted surgery for upper tract urothelial carcinoma (UTUC) in patients with complex renal anomalies such as a horseshoe kidney.
马蹄肾是最常见的肾脏融合异常，其独特的解剖结构和异常血管给手术带来了重大挑战，尤其是在诸如尿路上皮癌等恶性疾病中。我们报告一例使用达芬奇Xi®手术系统（直观外科公司，加利福尼亚州桑尼维尔）为一名患有与马蹄肾相关的右下输尿管癌患者进行机器人辅助右肾输尿管切除术的病例。该手术使用达芬奇Xi®系统以机器人方式完成，耗时207分钟，失血极少。病理诊断为高级别尿路上皮癌（pT2），手术切缘阴性，输尿管肿瘤附近有一个阳性淋巴结（N1）。术后过程顺利，24个月时未观察到复发。该病例证明了机器人辅助手术治疗复杂肾脏异常（如马蹄肾）患者的上尿路尿路上皮癌（UTUC）的安全性和有效性。
