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Retroperitoneoscopic renal pelvis resection as treatment of the urothelial tumor in a solitary kidney.

Wojtarowicz M, Słojewski M, Gołąb A, Petrasz P - Cent European J Urol (2013)

Bottom Line: Urothelial carcinoma of the upper urinary tract is relatively rare.In selected cases organ sparing surgery is justified.We present the case of the tumor of the kidney pelvis in a solitary organ where laparoscopic approach was successfully applied.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland.

ABSTRACT
Urothelial carcinoma of the upper urinary tract is relatively rare. The standard treatment is invariably radical nephroureterectomy. In selected cases organ sparing surgery is justified. We present the case of the tumor of the kidney pelvis in a solitary organ where laparoscopic approach was successfully applied.

No MeSH data available.


Related in: MedlinePlus

Excision of the tumor.
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Figure 0004: Excision of the tumor.

Mentions: Patient underwent ureterorenoscopy with the intention to confirm the presence of the papillary lesion of the right renal pevis. During the procedure, the access to the upper part of the ureter and renal pelvis was impossible due to the kinking of the ureter. The ascending pyelogram was performed, the Double–J ureteral stent inserted, and the patient was scheduled for the operation. The risk of perioperative bleeding after a percutaneous access which may require nephrectomy of the solitary kidney was rated higher then after the laparoscopic surgery. Considerable experience in laparoscopy was an additional factor. The option of retroperitoneal laparoscopic approach was offered to the patient. After induction of the general anaesthesia, the patient was placed in the lateral position. Retroperitoneal approach, according to the previously described technique was used [7]. The ureter, renal pelvis and lower pole of the kidney were prepared typically. After the release of ureter (Figure 2), pelvis was open and the papillary tumor was visualized (Figure 3). The tumor was resected with as much wide as possible margin of healthy pelvic tissue (Figure 4). In order to avoid the spillage the specimen was placed in the plastic bag (Figure 5). The renal pelvis was reconstructed with a continuous suture (Figure 6). Postoperative course was uncomplicated. The patient was discharged home in a good condition on the 6th day after the surgery. Pathology report revealed TCC pTaG2. Two months after surgery the patient had taken ultrasound control. Examination revealed no hydronephrosis and no tumor recurrence, although a longer follow–up is needed to be certain the treatment strategy was safe and efficient.


Retroperitoneoscopic renal pelvis resection as treatment of the urothelial tumor in a solitary kidney.

Wojtarowicz M, Słojewski M, Gołąb A, Petrasz P - Cent European J Urol (2013)

Excision of the tumor.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3974472&req=5

Figure 0004: Excision of the tumor.
Mentions: Patient underwent ureterorenoscopy with the intention to confirm the presence of the papillary lesion of the right renal pevis. During the procedure, the access to the upper part of the ureter and renal pelvis was impossible due to the kinking of the ureter. The ascending pyelogram was performed, the Double–J ureteral stent inserted, and the patient was scheduled for the operation. The risk of perioperative bleeding after a percutaneous access which may require nephrectomy of the solitary kidney was rated higher then after the laparoscopic surgery. Considerable experience in laparoscopy was an additional factor. The option of retroperitoneal laparoscopic approach was offered to the patient. After induction of the general anaesthesia, the patient was placed in the lateral position. Retroperitoneal approach, according to the previously described technique was used [7]. The ureter, renal pelvis and lower pole of the kidney were prepared typically. After the release of ureter (Figure 2), pelvis was open and the papillary tumor was visualized (Figure 3). The tumor was resected with as much wide as possible margin of healthy pelvic tissue (Figure 4). In order to avoid the spillage the specimen was placed in the plastic bag (Figure 5). The renal pelvis was reconstructed with a continuous suture (Figure 6). Postoperative course was uncomplicated. The patient was discharged home in a good condition on the 6th day after the surgery. Pathology report revealed TCC pTaG2. Two months after surgery the patient had taken ultrasound control. Examination revealed no hydronephrosis and no tumor recurrence, although a longer follow–up is needed to be certain the treatment strategy was safe and efficient.

Bottom Line: Urothelial carcinoma of the upper urinary tract is relatively rare.In selected cases organ sparing surgery is justified.We present the case of the tumor of the kidney pelvis in a solitary organ where laparoscopic approach was successfully applied.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland.

ABSTRACT
Urothelial carcinoma of the upper urinary tract is relatively rare. The standard treatment is invariably radical nephroureterectomy. In selected cases organ sparing surgery is justified. We present the case of the tumor of the kidney pelvis in a solitary organ where laparoscopic approach was successfully applied.

No MeSH data available.


Related in: MedlinePlus