Archivos espanoles de urologia · 2008
[Extracorporeal tumorectomy and autotransplantation in a patient with a single kidney and a multicentric clear cell carcinoma].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Cortés-González Jeff R, Arratia-Maqueo Jorge A, Ortiz-Lara Gerardo E, Escobedo Miguel, Gutiérrez-González Adrián
Аннотация
OBJECTIVE: To demonstrate that "bench surgery" and autotransplantation are still alternatives in the treatment of complex renal cancer cases.
METHODS: 58 y/o female with history of radical nephrectomy due to renal cancer who asked for medical attention because of back pain. Renal masses were found during her evaluation and she was referred to our service.
RESULTS: Lumbar incision was the preferred approach. After removal, the kidney was irrigated with EuroCollins solution and bench surgery was performed. Cold ischemia time was 63 minutes. The kidney was transplanted into the right pelvic region. Diuresis was immediately achieved after vascular anastomosis. Lich-Gregoir ureteral implant was carried out. During the first 48 hrs no complication was reported, urine output was about 80 cc/hour. She eventually developed renal failure and after 6 sessions of hemodialysis recovered to void in the previous volume range. She had a urinary leak that was resolved with CFT-guided percutaneus drainage. Twelve months after the procedure, she has no complaints; serum creatinine is 1.6 mg/dl and CT scan shows no evidence of recurrences.
CONCLUSIONS: Bench surgery is still a therapeutic alternative for the treatment of complex renal cancer cases in order to avoid dialysis.
METHODS: 58 y/o female with history of radical nephrectomy due to renal cancer who asked for medical attention because of back pain. Renal masses were found during her evaluation and she was referred to our service.
RESULTS: Lumbar incision was the preferred approach. After removal, the kidney was irrigated with EuroCollins solution and bench surgery was performed. Cold ischemia time was 63 minutes. The kidney was transplanted into the right pelvic region. Diuresis was immediately achieved after vascular anastomosis. Lich-Gregoir ureteral implant was carried out. During the first 48 hrs no complication was reported, urine output was about 80 cc/hour. She eventually developed renal failure and after 6 sessions of hemodialysis recovered to void in the previous volume range. She had a urinary leak that was resolved with CFT-guided percutaneus drainage. Twelve months after the procedure, she has no complaints; serum creatinine is 1.6 mg/dl and CT scan shows no evidence of recurrences.
CONCLUSIONS: Bench surgery is still a therapeutic alternative for the treatment of complex renal cancer cases in order to avoid dialysis.