Experience of diagnosis and treatment for renal multiple malignant tumors / 中华泌尿外科杂志

ABSTRACT

Objective To investigate the diagnosis and treatment of ipsilateral multiple renal malignant tumors.Methods 4 patients with multiple renal malignant tumors were retrospectively reviewed from May 2013 to November 2017.All cases were males,with average age of 64 years old (ranging 54-82 years old).Two cases were found thai tumor located in right side.The duration of disease ranged from 7 days to 6 months,with an average of 2 months.One case was found the tumor due to the complaining of lumbar discomfort,and other 3 cases were found by physical examination.The number of tumors was 2 in 1 case,and 3 in 3 cases.The sonographic features of the tumors were iso-echoic nodules.CT showed irregular soft tissue shadow,partially prominent outside the kidney,and heterogeneous enhanced after enhancement.3 cases were undergone laparoscopic radical nephrectomy and 1 case which was solitary kidney,was undergone laparoseopic partial nephrectomy.Results All operations were performed successfully.3 cases were undergone laparoscopic radical nephrectomy,which the operative time was 189-271 min (average,230 min),and blood loss was 50-100 ml (mean 83 ml).Postoperative hospitalization time was 5-14 days,average 9.7 days.1 case occurred intestinal obstruction after surgery,which was improved after treatment.1 case was found the close distance of 3 tumors during the laparoscopic surgery.In order to short the ischemic duration,open surgery conversion was performed in this case.The total operation time was 207min.The ischemic time was 15min and blood loss was 50 ml.The postoperative hospital stay was 6 days.Pathological reported that 3 cases were clear cell carcinoma,another 1 case was clear cell carcinoma with papillary carcinoma.All patients were followed up for 2-55 months (mean 38 months).No recurrence sign was recorded in all cases.Conclusion Ipsilateral multiple renal malignant tumors are rare,laparoscopic radical nephrectomy is effectie.Meanwhile,partial nephrectomy can also be chosen in some optimal cases.