Korean J Urol.  2009 Mar;50(3):288-292.

Video-Assisted Minilaparotomy Surgery (VAMS): Challenging Cases of Nephron-Sparing Surgery in a Solitary Kidney

• Koo KC
• Han WK
• Yang SC

Abstract

Although radical nephrectomy is the mainstay in the surgical management of renal cell carcinoma (RCC), a solitary kidney with RCC is an imperative indication for nephron-sparing surgery (NSS). In this rare setting, radical nephrectomy can potentially render the patient anephric, leading to dialysis or renal transplantation. Although open surgery is still the gold standard for NSS, there has been an upsurge in the number of minimally invasive NSS procedures that have demonstrated excellent long-term oncologic, surgical, and functional outcomes. Complex renal tumors in the setting of a solitary kidney add an additional challenge to minimally invasive NSS. Here we describe 3 complex cases of RCC in a solitary kidney treated successfully by video-assisted minilaparotomy surgery-NSS.

Keyword

Laparotomy; Nephrectomy; Renal cell carcinoma

MeSH Terms

Carcinoma, Renal Cell
Dialysis
Humans
Kidney
Kidney Transplantation
Laparotomy
Nephrectomy

Figure

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  Fig. 1 (A) Endophytic tumor. Computed tomography scan showing a solitary left kidney with a 2.5 cm solid tumor located near the renal hilum adjacent to the renal hilar vessels. (B) The cut surface of the specimen showing a well-demarcated, firm, solid yellowish mass (1.5×1.3 cm). (C) Contrasted computed tomography scan showing a well enhancing kidney without endophytic tumor recurrence.

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  Fig. 2 (A) Computed tomography scan showing a remnant left kidney with a 6.5 cm solid mid/lower renal mass. (B) The cut surface of the specimen showing a well-defined, ovoid, golden yellow, soft solid mass measuring 5.5×4.1 cm. (C) Contrasted computed tomography scan showing a well enhancing remnant left horseshoe kidney without tumor recurrence.

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  Fig. 3 (A) Hilar tumor. Computed tomography scan showing a solitary left kidney with a 5.5 cm solid tumor abutting the renal pelvis and branches of the renal hilar vessels. (B) The cut surface of the specimen showing a firm, solid, golden yellow, ill-defined mass measuring 7.5×6×5 cm. (C) Contrasted computed tomography scan showing a well enhancing left kidney without tumor recurrence.

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