Unilateral Renal Tumor Cryoablation and Contralateral Radical Nephrectomy of Bilateral Renal Tumors by Transumbilical 3D Multichannel Laparoendoscopic Single-Website Surgical procedure.
J Endourol Case Rep. 2018;four(1):53-58
Authors: Yu G, Zhang Okay, Li W, Li L, Zhao Y, Wang Y, Xu M, Da J, Dong G, Wang Z, Xu B
Background: Unilateral renal tumor cryoablation and contralateral radical nephrectomy of bilateral renal tumors had been carried out by transumbilical three-dimensional (3D) multichannel laparoendoscopic single-site (LESS) surgical procedure, in an try to confirm the feasibility and security of the process, sum up the operational expertise, and consider the surgical consequence. Case Presentation: This was a 47-year-old feminine affected person with a physique mass index of 27.34?kg/m2 with out backache, low again ache, hematuria, urinary urgency, frequent urination, dysuria, and different signs. Distinction-enhanced CT scan of the kidney on admission confirmed 4 lots within the left kidney and two lots in the appropriate kidney. Preoperative serum creatinine (SCr) was 87??mol/L. Operation was carried out underneath common anesthesia by first laying the affected person in a left lateral place. A 2-cm longitudinal transumbilical pores and skin incision was made to show the appropriate kidney for full dissection of the 2 tumors. First, puncture biopsy was carried out, after which two freeze-thaw cryoablation cycles for the 2 tumors had been carried out. Eventually, the affected person was laid in a proper lateral place for radical nephrectomy of the left kidney. The operative length, cryoablation time, and estimated blood loss had been 200 minutes, 40 minutes, and 100?mL, respectively. Postoperative pathological examination revealed clear-cell renal cell carcinoma. The correct glomerular filtration charge examined was 42.36?mL/minute and SCr was 131??mol/L at day 5 after surgical procedure. There was no proof of distinction enhancement on the cryoablative area as proven by renal contrasted CT scan carried out four days after surgical procedure and renal contrasted MRI scan carried out 6 weeks after surgical procedure, indicating that there was no tumor remnant or recurrence. Conclusion: Our preliminary expertise exhibits that the remedy of bilateral renal tumors with unilateral renal tumor cryoablation and contralateral radical nephrectomy by transumbilical 3D LESS is secure, possible, and efficient. It might show to be a viable choice for sufferers with important comorbidities and an insensitive remedy intention.
PMID: 29682611 [PubMed]