Category: Laparoscopy: Upper Tract - Malignant
Introduction & Objective : Partial nephrectomy entails complete local resection of a renal tumor while leaving the largest possible amount of normal functioning parenchyma in the involved kidney.
Methods : Case of a 51-year-old male patient whose CT scan revealed multipletumors in both kidneys and a lesion in the left adrenal gland.3 The relative function of the left kidney measured by renal scintigraphy was 46%, the right, 54%.
Results : The operation lasted 220 mins, the blood loss equalled 350 cc, total ischemia time – zero.The pathology report proved papillary renal cell carcinoma in all 8 extracted tumors, an adenoma in the adrenal gland. The operation on the right side was also started as a laparoscopic retroperitoneal procedure. We mobilized the renal vessels and excised several minor lesions without ischemia. Considering the high risk of massive bleeding as well as for better visualization and to avoid a positive surgical margin we clamped the renal artery before tackling the largest tumor located at the anterior surface near the renal sinus. The total ischemia time equaled 12 mins. All of the right kidney tumors turned out to be papillary renal cell carcinoma.
Conclusions : The fundamental problem of multiple bilateral cancer is as follows: the condition is systemic but requires organ-preserving approach. In this light laparoscopic surgery performed in the conditions of partial ischemia may be a promising alternative in the management of multiple bilateral kidney cancer.
Volgograd State Medical University
Volgograd, Volgograd, Russia
I Studied urology at Volgograd state medical University. Residency in the Volgograd regional uronephrological centre by Professor Perlin D. the Main activities associated with the treatment of kidney cancer, prostate cancer and endourology.