Unilateral Renal Tumor Cryoablation and Contralateral Radical Nephrectomy of Bilateral Renal Tumors by Transumbilical 3D Multichannel Laparoendoscopic Single-Site Surgery.
机构：[1]Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.[2]Department of Urology, The People's Hospital of Xiangyun, Dali Bai Autonomous Prefecture, Yunnan, China.
Background:
Unilateral renal tumor cryoablation and contralateral radical nephrectomy of bilateral renal tumors were performed by transumbilical three-dimensional (3D) multichannel laparoendoscopic single-site (LESS) surgery, in an attempt to verify the feasibility and safety of the procedure, sum up the operational experience, and evaluate the surgical outcome.
Case Presentation:
This was a 47-year-old female patient with a body mass index of 27.34 kg/m2 without backache, low back pain, hematuria, urinary urgency, frequent urination, dysuria, and other symptoms. Contrast-enhanced CT scan of the kidney on admission showed four masses in the left kidney and two masses in the right kidney. Preoperative serum creatinine (SCr) was 87 μmol/L. Operation was performed under general anesthesia by first laying the patient in a left lateral position. A 2-cm longitudinal transumbilical skin incision was made to expose the right kidney for complete dissection of the two tumors. First, puncture biopsy was performed, and then two freeze-thaw cryoablation cycles for the two tumors were performed. At last, the patient was laid in a right lateral position for radical nephrectomy of the left kidney. The operative duration, cryoablation time, and estimated blood loss were 200 minutes, 40 minutes, and 100 mL, respectively. Postoperative pathological examination revealed clear-cell renal cell carcinoma. The right glomerular filtration rate tested was 42.36 mL/minute and SCr was 131 μmol/L at day 5 after surgery. There was no evidence of contrast enhancement at the cryoablative region as shown by renal contrasted CT scan performed 4 days after surgery and renal contrasted MRI scan performed 6 weeks after surgery, indicating that there was no tumor remnant or recurrence.
Conclusion:
Our preliminary experience shows that the treatment of bilateral renal tumors with unilateral renal tumor cryoablation and contralateral radical nephrectomy by transumbilical 3D LESS is safe, feasible, and effective. It may prove to be a viable option for patients with significant comorbidities and an insensitive treatment intention.
基金：
National Natural Science
Foundation of China (Grant No. 81472398 to B.X.), Shanghai
Science and Technology Commission ‘‘Science and Technology
Star’’ Talent Foundation (Grant No. 15QA1404900 to
B.X.), and ‘‘Seed Founding of Shanghai Ninth People’s Hospital,
Shanghai Jiao Tong University School of Medicine’’
(Grant No. JYZZ006 to G.Y.).
语种：
外文
PubmedID：
第一作者：
第一作者机构：[1]Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.[2]Department of Urology, The People's Hospital of Xiangyun, Dali Bai Autonomous Prefecture, Yunnan, China.
共同第一作者：
通讯作者：
通讯机构：[1]Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.[*1]Department of Urology Shanghai Ninth People’s Hospital Shanghai Jiaotong University School of Medicine No. 639 Zhizaoju Road Shanghai 200011 China
推荐引用方式(GB/T 7714)：
Yu Guopeng,Zhang Ke,Li Wenzhi,et al.Unilateral Renal Tumor Cryoablation and Contralateral Radical Nephrectomy of Bilateral Renal Tumors by Transumbilical 3D Multichannel Laparoendoscopic Single-Site Surgery.[J].Journal of endourology case reports.2018,4(1):53-58.doi:10.1089/cren.2017.0120.
APA：
Yu Guopeng,Zhang Ke,Li Wenzhi,Li Long,Zhao Yanliang...&Xu Bin.(2018).Unilateral Renal Tumor Cryoablation and Contralateral Radical Nephrectomy of Bilateral Renal Tumors by Transumbilical 3D Multichannel Laparoendoscopic Single-Site Surgery..Journal of endourology case reports,4,(1)
MLA：
Yu Guopeng,et al."Unilateral Renal Tumor Cryoablation and Contralateral Radical Nephrectomy of Bilateral Renal Tumors by Transumbilical 3D Multichannel Laparoendoscopic Single-Site Surgery.".Journal of endourology case reports 4..1(2018):53-58
