Association of Squamous Cell Carcinoma with Nonfunctioning Kidney due to Renal Stone Disease

Introduction: Sqamous cell carcinoma accounts for 0.5-0.8%of all renal tumour. Squamous cell carcinoma (SCC) of therenal pelvis is a rare neoplasm and is usually associated withlong standing renal stone disease. There is lack of definiteclinical presentation and inconclusive imaging finding, thesetumors are high grade, highly aggressive with poor prognosis.Histopathology report is hallmark for diagnosis.Material and methods: Our study is Retrospective studywith sample size of 5 patient (3 male and 2 female), presentingcomplaints of all patients had a chronic history of renal stonedisease with loin pain presented during last 2 year of period inUrology department. All patient were evaluated with routinepreoperative blood investigation, DTPA renogram, and NCCT(KUB), found to have nonfunctioning kidney underwentsimple nephrectomy.Result: In our study mean age is 52 year, 3 male and 2 female,mean operative time- 2hr,during postoperative period 3patient have uneventful postoperative course,1 patient haveatrial fibrillation,1 patient have a suture site infection, averagehospital stay 4.5 days. Postoperative histopathology reportconfirmed presence of squamous cell carcinoma, 3 patient onregular follow up with no evidence of recurrence, 1 patientdies during follow up and 1 patient lost follow up.Conclusion: Primary squamous cell carcinoma of kidney arerare aggressive tumour with poor prognosis. As this tumor isassociated with renal stone and non functioning kidney, theyshould be evaluated with newer imaging technology for earlydetection of tumour.

Retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney / 中国医师进修杂志

Objective To investigate the clinical application value of retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney.Methods Fifty-four cases of retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney were reviewed,including 9 cases with nonfunctioning tuberculosis pyonephrosis,18 cases with infection nonfunctioning pyonephrosis and 27 cases of nonfunctioning hydronephrosis.Fifty-four cases were received retroperitoneal laparoscopic nephrectomy,tuberculous and infection pyonephrosis underwent laparoscopic resection surrounding adipose capsule,nonfunctioning hydronephrosis underwent laparoscopic resection by pumping water to increase the peritoneal space.Results The operation of 54 cases were perfomed successfully.None of the patient required conversion to open surgery.During the surgery,1 case showed mild extravasation of cheese-like pus induced by laceration of the kidney capsule;2 cases had injuried on the peritoneum.The mean operation time was 125 (95-230) min,the mean blood loss was 84 (50-420) ml.All patients showed primary healing of the wound,the patients were discharged from the hospital in 6 to 11 d (mean 7.5 d).After followed up for 5-27 months,none of them had long-term complication.Conclusions Retroperitoneal laparscopic nephrectomy for nonfunctioning kidney has advantages of minimal invasion,less blood loss and quicker recovery,so it is a fairly safe and effective procedure for nonfunctioning kidney.

Standard laparoscopic vs laparoendoscopic single-site nephrectomy for benign nonfunctioning kidney: A comparison of therapeutic outcomes / 第二军医大学学报

Objective To compare the therapeutic outcomes of standard laparoscopic and laparoendoscopic single-site (LESS) nephrectomy for benign nonfunctioning kidney. Methods From September 2009 to August 2013, a single urologist group in our center performed 72 transperitoneal laparoscopic nephrectomies for benign nonfunctioning kidney, with 50 undergoing LESS (group A) and 22 undergoing standard laparoscopic surgery (group B). The clinical data of the two groups were analyzed and the therapeutic outcomes were compared between the two groups. Results The operation was successfully performed in all cases, with no conversion to open surgery. Compared with standard laparoscopic group, the LESS group had significantly lower postoperative pain score (4.3 ± 1.0 vs 3.7 ± 0.8, P = 0.015), quicker bowel function recovery ([58.1 ± 16.1] hvs [49.2 ± 14.0] h, P = 0.032) shorter drainage duration ([3.9 ± 1.5] dvs [2.8 ± 1.1] d, P = 0.003), shorter post-operative hospital stay ([7.3 ± 3.1] d vs [6.3 ± 3.4] d, P = 0.048), and a better cosmetic satisfaction score (7.4 ± 0.9 vs 8.0 ± 0.6, P = 0.001). The operative time and intraoperation blood loss were not significantly different between the two groups. Conclusion Compared to standard laparoscopic nephrectomy, transumbilical LESS nephrectomy offers a quicker recovery of bowel function, shorter drainage duration, a better postoperative pain control, and a better cosmetic satisfaction for benign nonfunctioning kidney, but its long-term therapeutic effect needs to be further verified.

Significance of Nephrectomy in Renal Tuberculosis Patients with Negative Urine (AFB) Culture and Asymptomatic Nonfunctioning Kidney / 대한비뇨기과학회지

PURPOSE: The aim of this study was to evaluate the surgical treatment of incidentally detected, asymptomatic, unilateral nonfunctioning tuberculous kidney. MATERIALS AND METHODS: Thirty-three patients with incidentally detected, asymptomatic, unilateral nonfunctioning kidney, negative urine AFB culture and radiologic diagnosis of renal tuberculosis were reviewed. They were divided into three groups: surgical, medical, and observation groups. Twelve patients in the surgical group were nephrectomized at initial diagnosis. Eleven patients in the medical group received anti-tuberculous medication with isoniazid, rifampin, and pyrazinamide for 4 months. Ten patients in the observation group remained under observation. RESULTS: There was no evidence of decreased renal function or recurrence of renal tuberculosis in the surgical and medical groups. Pathologic confirmation of renal tuberculosis was obtained in all nephrectomy patients. The follow-up loss rate of the surgical group (7.7%) was lower than that of the other groups (p<0.05). CONCLUSIONS: Nephrectomy is more acceptable than either medicine or observation. (1) Because preoperative chemotherapy was not justified in the case of negative urine AFB culture, pathologic confirmation was necessary. (2) Nephrectomy associated morbidity was quite low. (3) The follow-up loss rate of the surgical group was lower than that of the other groups. Short course anti-tuberculous medication should be administered after nephrectomy.

Therapeutic options of tuberculous nonfunctioning kidneys / 대한비뇨기과학회지

We analyzed 57 patients with tuberculous nonfunctioning kidneys, which were diagnosed pathologically or bacteriologically at Seoul National University, from October 1981 to December 1989. The patients were divided into 3 groups according to the treatment ; Group 1 : 12 patients, only chemotherapy for more than 12 months ; Group 2 :32, nephrectomy and chemotherapy for more than 6 months ; Group 3 . 13, nephrectomy and chemotherapy only for 3 months. As a standard antituberculous regimen, isoniazid, rifampin, and ethambutol were used, and pyrazinamide was added in 15 patients. The follow-up tests were urinalysis, urine AFB smear and culture, and intravenous pyelography. The duration of the follow-up was 6 to 1O8 months, with a mean of 23.3 months. There was no evidence of recurrence in any patient among the 3 groups. Two postoperative complications (hematoma and fistula formation) occurred in 45 nephrectomized patients. Pathologic examination of the resected kidneys revealed findings compatible with tuberculosis in all patients of Groups 2 and 3. Coexisting cortical adenomas were found incidentally in 2 patients. Final diagnoses of the other 2 patients were hydronephrosis and chronic pyelonephritis without any evidence of tuberculosis, although these 2 patients were excluded in this study. Severe drug toxicity occurred in 7 patients that belonged to Groups 1 and 2. In conclusion, early nephrectomy for accurate diagnosis and removal of infective foci was the justifiable initial procedure, and this should be followed by postoperative antituberculous chemotherapy for the shortest acceptable period in tuberculous nonfunctioning kidneys. In highly selective cases where the lesion is completely localized in one kidney, we can consider early nephrectomy and a 3-month course of chemotherapy as one treatment modality.