體外腎臟保留手術併自體移植治療單腎之上泌尿道泌尿上皮癌患者-單一機構之經驗
鄭人豪、洪晟鈞、王樹吉、裘坤元
台中榮民總醫院 外科部 泌尿科
Ex-vivo nephron-sparing surgery and autotransplantation for upper urinary tract urothelial carcinoma in solitary kidney:A single-institution experience.
Jen-Hao Cheng, Sheng-Chun Hung, Shu-Ji Wang, Kun-Yuan Chiu
Divisions of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
Purpose: Nephroureterectomy with bladder cuff excision for upper urinary tract urothelial carcinoma(UUT-UC) is the gold standard therapy. But dialysis will be inevitable after surgery in patient with UC of solitary kidney. We report solitary kidney patients with UUT-UC treated with bench surgery with renal autotransplantation in our hospital.
Materials and Methods: From September 2007 to September 2017 at our institution, total 3 patients with solitary kidney, diagnosed as UUT-UC, underwent nephron-sparing surgery by nephrectomy, ex vivo tumor excision, and autotransplantation. Patient characteristics Tumor characteristics, renal function and tumour control were recorded.
Results:. The histopathological status were pTaN0M0,low grade, pTaN0M0,high grade and pT1N0M0, high grade. All patients are currently alive without evidence of local recurrences nor distant metastasis. None of them required postoperative hemodialysis during the follow-up period.
Conclusions: Ex-vivo nephron-sparing surgery and renal autotransplantation for renal urothelial cancer in solitary kidneys is feasible, but should only be performed in selected patients. Dialysis and renal replacement can be avoided.