後腹腔腫瘤併大血管侵犯與腎臟血管包埋接受完全切除及腎臟保留手術
張殷綸1、林威宇1、林建兆2、黃子豪3、郭亮鉾3、邱國雄1,楊紫馨1,
黃國財1,林健煇1,黃雲慶1,何東儒1,陳志碩1
1嘉義長庚紀念醫院外科部
1泌尿外科，2心臟外科3一般外科
Complete resection of great vessels involved and renal pedicle encased pheochromocytoma and huge adrenocortical tumor with renal preservation
Yin-Lun Chang1, Wei-Yu Lin1, Jain-Zhao Lin 2, Zi-Hao Huang 3, Kuo-Hsiung Chiu1, Tzu-Hsin Yang1, Kuo-Cai Huang1, Jian-Hui Lin1, Yung-Chin Huang1, Dong-Ru Ho1 and Chih-Shou Chen1
1Division of Urology, Department of Surgery, Chiayi Chang Gung Memorial Hospital
2 Division of Cardiovascular Surgery, Department of Surgery, Chiayi Chang Gung Memorial Hospital
3 Division of General Surgery, Department of Surgery, Chiayi Chang Gung Memorial Hospital
Purpose: The management of great vessels involved and renal pedicle encased pheochromocytoma or retroperitoneal tumor without sacrifice of kidney was a challenge for urologist. We describe our strategies for complete resection of challenging retroperitoneal tumor with renal preservation.
Materials and Methods: Data were collected retrospectively from a series of 5 patients who, from 2014 to 2016, underwent complete resection with renal preservation by interdisciplinary team comprised of urologists, GS and CVS surgeons.
Results: Among the tumors of 5 cases, there were two cases with hypertensive crisis, two cases with renal pedicles encasement, one case of adrenocortical tumor with diameter around 17cm, and one case with recurrent malignant pheochromocytoma post repeat resection and radiotherapy. Peri-operative preparation included: angiography with embolization, insertion of ureter stent and great vessel graft. Laparoscopy surgery was undertaken in one case and the rest were by open surgery. In addition to complete resection, the kidney were all preserved without nephrectomy. There was no peri-operative or post-operative complication and all patients are disease-free to date.
Conclusion: By multidisciplinary cooperation, complete and safe resection of great vessels involved and renal pedicle encased pheochomocytoma tumor or retroperitoneal tumor with preservation of kidney is feasible.