Laparoscopic Partial Resection of Tu Formation of a Kidney, Combined with Pyeloplasty

Abstract

Introduction: Laparoscopic partial nephrectomy is increasingly performed for selected small renal masses as it has been shown to provide similar oncological outcomes to open partial nephrectomy. However, LPN is a technically challenging procedure. The need for hilus clamping is associated with the possibility of renal damage associated with warm ischemia.

Pyeloplasty is a method of surgical treatment for obstruction of the pyeloureteral junction caused by stenosis or the presence of an aberrant vessel pressing externally. As a result, hydronephrosis of the kidney is observed, requiring the performance of deobstructive measures. Today, the classic method of open pyeloplasty has been replaced from the laparoscopic technique.

Objective: We present a clinical case of laparoscopic partial resection of Tu formation of the right kidney combined with laparoscopic pyeloplasty of the
same kidney.

Materials and Methods: A 62-year-old patient with established hydronephrosis of the right kidney and a nephrostomy placed in another medical institution. On this occasion, the patient made a consultation with a urologist with the aim of operative treatment and removal of the nephrostomy. The subsequent CT scan of the abdomen revealed hydronephrosis of right kidney with stenosis of the PUJ, an additional finding was Tu formation with a diameter of 40 mm., located in the area of the upper pole, on the dorsal surface of the kidney.

A laparoscopic pyeloplasty was performed, followed by a partial resection of the Tu formation. The operative time was 210 min. Blood loss 150 ml. No complications were observed in the early and late operative period. The patient was discharged on the 5th day.

Conclusion: The laparoscopic technique can also be used in more complicated cases, maintaining its advantages over open surgery - mini-invasiveness, short hospital stay, minimal blood loss and quick recovery of the patient.