Ces Urol 2021, 25(1):13-14

Laparoscopic nephron-sparing surgery in a patient with multiple tumours in a solitary kidney

Michael Pešl¹, Květoslav Novák¹, Petr Macek², Jan Novák¹, Pavel Dundr³, Tomáš Hanuš¹

¹ Urologická klinika VFN a 1. LF UK, Praha

² Departement of Urology, Institut Montsouris, Paris, France

³ Patologický ústav VFN a 1. LF UK, Praha

Pešl M, Novák K, Macek P, Novák J, Dundr P, Hanuš T. Laparoscopic nephron-sparing surgery in a patient with multiple tumours in a solitary kidney.

Aim: To present a video of laparoscopic kidney resection in a patient with multiple tumours of a right sided solitary kidney.

Material and methods: Female patient, 63 years of age, after open transperitoneal nephrectomy on the left, histology confirmed clear cell renal carcinoma (pT2b G3). Two new tumours in the right solitary kidney were found during staging CT. The patient was indicated for laparoscopic nephron-sparing surgery. We found another five small tumours during the procedure. PADUA score: 2x, 9a, 5x, 7a. We resected all the tumours into macroscopicaly negative margins from four resection defects. We used selective clamping (WIT 19 min) during resection of the biggest tumour. We used V-Loc™ stitch to close the defects.

Results: Blood loss was up to 100 ml, no significant renal function impairment was detected. No postoperative complicaions were present. Total hospital stay was 10 days. Result of histopathologic assesment was clear cell carcinoma pT1a G2, there was positive surgical margin in one tumor (the biggest tumour, 12x11 mm) of 2 mm in size.

Conclusions: Laparoscopic nephron-sparing surgery of solitary kidney is a safe, feasible, but technically demanding method of multiple kidney tumours treatment. The patient is free of disease after 12 months from the surgery.

Keywords: Laparoskopie, resekce ledviny, tumor ledviny.

Received: November 24, 2020; Revised: March 10, 2021; Accepted: March 14, 2021; Prepublished online: March 15, 2021; Published: March 30, 2021