等回声完全内生型肾肿瘤术中超声造影引导行肾部分切除术1例报告

Intraoperative contrast-enhanced ultrasound guided surgery for isoechoic completely endogenous renal tumor:a case report

完全内生型肾肿瘤手术治疗时,术中常规应用超声辅助定位,但对于等回声肾肿瘤,常规超声的定位引导能力会降低。本文报道1例右肾肿瘤患者,肿瘤直径约2.3 cm×1.7 cm,肿瘤密度与肾实质相当,应用超声造影实时引导行腹腔镜肾部分切除术,术中发现肿瘤乏血供,通过造影剂对比,肿瘤轮廓显影清晰,标记准确,顺利完成手术。病理诊断为低度恶性潜能多房囊性肾肿瘤,切缘阴性。术后恢复良好,未出现并发症。术后随访6个月未见肿瘤复发、转移,肾功能良好。

Intraoperative ultrasound assisted localization is routinely used in the surgical treatment of completely endogenous renal cell tumor,however the localization and guidance ability of conventional ultrasound will decline to a certain extent for isoechoic renal tumor.A 62 years old female patient with right renal tumor was reported.The tumor diameter was about 2.3 cm×1.7 cm,equivalent to the isoechoic of kidney.Laparoscopic partial nephrectomy was performed under the real-time guidance of contrast-enhanced ultrasound.The tumor was found to be lack of blood supply during the operation,and the tumor contour was clearly developed by contrast agent.The operation was successfully completed,and the pathological diagnosis was polycystic renal tumor with low malignant potential.The incisional margin was negative.The patient recovered well after operation without complications.No recurrence or metastasis was found after 6 months of follow-up.The renal function was good.