Laparoscopic partial nephrectomy for a renal tumor with tumor-feeding artery ligation: Left renal cell carcinoma in the posterior mid zone

Autor: Yosuke Shimizu, Noriyasu Takao, Tomoyuki Oida, Yasumasa Shichiri, Hiroshi Kanamaru
Rok vydání: 2004
Předmět:
Zdroj: International Journal of Urology. 11:1019-1023
ISSN: 0919-8172
DOI: 10.1111/j.1442-2042.2004.00945.x
Popis: The most serious problem regarding a laparoscopic partial nephrectomy is how to perform bloodless excision without causing renal ischemia in a limited working space. We report the case of a 65-year-old man with left small renal cell carcinoma in the posterior mid zone who underwent a laparoscopic partial nephrectomy through a retroperitoneal approach by carrying out the ligation of the tumor-feeding artery, but without clamping the renal pedicle. Both preoperative abdominal computed tomography (CT) and intraoperative ultrasonography revealed the tumor to be fully encapsulated. The tumor-feeding artery could be exposed by dissection from the renal hilum and, after an arterial ligation, tumor resection with a safety margin was smoothly performed with minimal bleeding. Postoperatively, CT revealed a limited defect of the renal parenchyma and excretory pyelography showed no urine leakage or urinary tract obstruction. The preoperative and postoperative creatinine levels were 0.66 and 0.69 mg/dL, respectively. As a result, a tumor-feeding artery ligation with a laparoscopic partial nephrectomy for left renal cell carcinoma in the posterior mid zone is considered to be an effective surgical modality which avoids renal ischemia and pelvic heat injury.
Databáze: OpenAIRE