V6-11: Laparoscopic Radical Heminephrouretectomy in Horseshoe Kidney with High-Grade Urothelial Cell Carcinoma and Single-Port Bladder Cuff Management: First Case Report.
Horseshoe kidney is a renal fusion congenital disorder, affecting up to 0.25% of the general population. High-grade urothelial carcinoma represents about 5-7% of all renal tumors._x000D_ We describe the laparoscopic approach of hemi-nephroureterectomy and lymphadenectomy with the single-port bladder cuff resection in a horseshoe kidney with upper urinary tract urothelial cell carcinoma.
Male, 50 years old patient with an incidental endoscopic finding of a right renal pelvic tumoral lesion. The imaging studies revealed a horseshoe kidney._x000D_ _x000D_ The angio-MRI of the abdomen reveals a tumor in the renal pelvis and in the first two-thirds of the ureter. The vascular artery study reveals a renal artery supplying blood to the tumoral lesion and the second artery to the inferior pole of the kidney._x000D_
Right laparoscopic radical hemi-nephroureterectomy with Isthmectomy and lymphadenectomy (perihiliar, paraaortic, precaval, and paracaval) whit single-port bladder cuff was performed without complications. The surgical specimen was all removed by the suprapubic incision of the single port._x000D_ _x000D_ The pathology shows a tumor confined to the renal pelvis; ureter tumor extension recognized with partial obstruction in its proximal two-thirds, without recognizing infiltration ureteral wall. lymph node negative for tumor involvement. TNM: pT1 High-Grade N 0 M 0. _x000D_ Six months follow-up is satisfactory without relapse._x000D_ _x000D_
This is the first case reported which describes the laparoscopic approach for hemi-nephroureterectomy with lymphadenectomy and simultaneously by single-port bladder cuff in horseshoe kidney with upper urinary tract urothelial cell carcinoma._x000D_ _x000D_ The single-port technique, allows an intravesical approach with a safe surgical margin while still attaining the benefits of a minimally invasive surgery._x000D_ _x000D_ This procedure is viable and safe, inclusive in structural anomalies such as the horseshoe kidney with favorable oncologic short-term results._x000D_ _x000D_