Robotic‐Assisted Laparoscopic Partial Nephrectomy for a 7‐cm Mass in a Renal Allograft

Robotic‐Assisted Laparoscopic Partial Nephrectomy for a 7‐cm Mass in a Renal Allograft

Treatment options for a suspicious renal mass in a renal allograft include radical nephrectomy or nephron‐sparing surgery (NSS). To our knowledge robotic‐assisted laparoscopic partial nephrectomy (RPN) as treatment for a renal mass in a transplant kidney has not been previously reported. We report t...

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Bibliographic Details
Published in:American journal of transplantation Vol. 11; no. 10; pp. 2242 - 2246
Main Authors: Kaouk, J. H., Spana, G., Hillyer, S. P., White, M. A., Haber, G.‐P., Goldfarb, D.
Format: Journal Article
Language:English
Published: Malden, USA Blackwell Publishing Inc 01-10-2011
Wiley
Subjects:
Adult
Biological and medical sciences
Digestive system. Abdomen
Endoscopy
Female
Humans
Investigative techniques, diagnostic techniques (general aspects)
Kidney neoplasm
Kidney Neoplasms - surgery
Kidney Transplantation
Kidneys
laparoscopy
Laparoscopy - methods
Medical sciences
Nephrectomy - methods
Nephrology. Urinary tract diseases
renal allograft
Robotics
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Tomography, X-Ray Computed
Tumors of the urinary system
Kidney disease
Endoscopic surgery
Urinary system disease
Kidney tumor
renal allograft
Transplantation
Laparoscopy
Homotransplantation
Kidney
Robotics
Mass
Treatment
Urinary system
Nephrectomy
Partial
Telemedicine
Kidney neoplasm
Graft
Endoscopy
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Summary:Treatment options for a suspicious renal mass in a renal allograft include radical nephrectomy or nephron‐sparing surgery (NSS). To our knowledge robotic‐assisted laparoscopic partial nephrectomy (RPN) as treatment for a renal mass in a transplant kidney has not been previously reported. We report the case of RPN for a 7‐cm renal mass in a transplanted kidney. A 35‐year‐old female with reflux nephropathy received a living‐related donor kidney transplant in 1986. At 24 years after transplantation she had a 7‐cm Bosniak III cystic mass of the allograft detected on computerized tomography (CT) scan. Preoperative creatinine was 2.2 mg/dL with an estimated glomerular filtration rate (eGFR) of 25 mL/min/1.73 m2. RPN was performed with bulldog clamping of the renal vessels, the graft was left in situ and immunosuppression was maintained postoperatively. Tumor diameter was 7.3 cm with a nephrometry score of 10a. Warm ischemia time (WIT) was 26.5 min. Estimated blood loss was 100 mL. There was no change between pre‐ and postoperative eGFR. There were no operative complications. Histology was papillary renal cell carcinoma type 1, nuclear grade 2. Margins were negative. RPN is a technically feasible treatment option for a suspicious renal mass in renal allografts. Robotic‐assisted laparoscopic partial nephrectomy in a renal allograft is feasible.
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ISSN:1600-6135
1600-6143
DOI:10.1111/j.1600-6143.2011.03655.x