BACKGROUND Ureteral reconstruction is a highly technical type of laparoscopic or open surgery.The incidence of ureteral injury is low;however,ureteral injuries tend to be overtreated.Robotic surgery for urinary recons...BACKGROUND Ureteral reconstruction is a highly technical type of laparoscopic or open surgery.The incidence of ureteral injury is low;however,ureteral injuries tend to be overtreated.Robotic surgery for urinary reconstructive surgery is growing in popularity,which has made procedures such as pyeloplasty,ureteroureterostomy,and ureteroneocystostomy possible,with minimal damage to the patient.To the best of our knowledge,this is the first report of robot-assisted laparoscopic pyeloureterostomy in Korea,in a 17-year-old female patient with a ureteral injury.CASE SUMMARY The patient,a 17-year-old girl without previous medical history,was presented at the emergency room and complained of abdominal and back pain.Tenderness in the right upper quadrant was observed on physical examination.Hemorrhage in the right perirenal space was observed without abdominal organ injuries on the initial enhanced abdomen computed tomography(CT)scan.Ureteral injury was not suspected at this time.The patient was stabilized via conservative treatment,but complained of right flank pain 3 wk later and revisited the emergency room.An enhanced abdominal CT scan revealed a huge urinoma in the right perirenal space with hydronephrosis of the right kidney.Retrograde and antegrade pyelography were performed.Extravasation and discontinuity of the ureter were found.A rupture of the ureteropelvic junction was diagnosed and reconstructive surgery was performed.After 3 mo,the patient did not complain of any symptoms without any abnormal radiologic findings.CONCLUSION This case report discusses the safety and effectiveness of this minimal invasive procedure as an alternative to conventional open or laparoscopic surgery.展开更多
BACKGROUND It is rare for urothelial and renal cell carcinomas to coexist in the same patient,and even rarer for them to be detected simultaneously.Because of this rarity,a standard treatment has not been established ...BACKGROUND It is rare for urothelial and renal cell carcinomas to coexist in the same patient,and even rarer for them to be detected simultaneously.Because of this rarity,a standard treatment has not been established and studies about overall survival are scarce.Therefore,physicians must modify treatments according to the individual’s situation and the stage of each disease.In recent years,with advances in the instruments and techniques,minimal invasive robotic surgeries have become available for advanced-stage or high-risk patients.CASE SUMMARY An 85-year-old woman with a medical history of hypertension and hyperlipidemia visited our institution.She had visited her local hospital complaining of intermittent,painless,gross hematuria that had started 3 mo earlier.On computed tomography,a right renal mass and left proximal ureteral mass with hydronephrosis were found simultaneously.We decided to perform robot-assisted surgery on both sides during one operation.Considering renal function and kidney loading,right partial nephrectomy was performed first,followed by left nephroureterectomy with bladder cuff excision.At the 6-mo follow-up,no specific symptoms were reported and dialysis was not considered.There were no unusual findings in the imaging study,and regular follow-up and imaging studies are scheduled.CONCLUSION This case report assessed the feasibility of simultaneous minimal invasive robotic surgery as an alternative to conventional open or laparoscopic surgery.展开更多
基金Supported by Soonchunhyang University Research Fund,No.20200024.
文摘BACKGROUND Ureteral reconstruction is a highly technical type of laparoscopic or open surgery.The incidence of ureteral injury is low;however,ureteral injuries tend to be overtreated.Robotic surgery for urinary reconstructive surgery is growing in popularity,which has made procedures such as pyeloplasty,ureteroureterostomy,and ureteroneocystostomy possible,with minimal damage to the patient.To the best of our knowledge,this is the first report of robot-assisted laparoscopic pyeloureterostomy in Korea,in a 17-year-old female patient with a ureteral injury.CASE SUMMARY The patient,a 17-year-old girl without previous medical history,was presented at the emergency room and complained of abdominal and back pain.Tenderness in the right upper quadrant was observed on physical examination.Hemorrhage in the right perirenal space was observed without abdominal organ injuries on the initial enhanced abdomen computed tomography(CT)scan.Ureteral injury was not suspected at this time.The patient was stabilized via conservative treatment,but complained of right flank pain 3 wk later and revisited the emergency room.An enhanced abdominal CT scan revealed a huge urinoma in the right perirenal space with hydronephrosis of the right kidney.Retrograde and antegrade pyelography were performed.Extravasation and discontinuity of the ureter were found.A rupture of the ureteropelvic junction was diagnosed and reconstructive surgery was performed.After 3 mo,the patient did not complain of any symptoms without any abnormal radiologic findings.CONCLUSION This case report discusses the safety and effectiveness of this minimal invasive procedure as an alternative to conventional open or laparoscopic surgery.
基金Supported by Soonchunhyang University Research Fund,No.1022-0015.
文摘BACKGROUND It is rare for urothelial and renal cell carcinomas to coexist in the same patient,and even rarer for them to be detected simultaneously.Because of this rarity,a standard treatment has not been established and studies about overall survival are scarce.Therefore,physicians must modify treatments according to the individual’s situation and the stage of each disease.In recent years,with advances in the instruments and techniques,minimal invasive robotic surgeries have become available for advanced-stage or high-risk patients.CASE SUMMARY An 85-year-old woman with a medical history of hypertension and hyperlipidemia visited our institution.She had visited her local hospital complaining of intermittent,painless,gross hematuria that had started 3 mo earlier.On computed tomography,a right renal mass and left proximal ureteral mass with hydronephrosis were found simultaneously.We decided to perform robot-assisted surgery on both sides during one operation.Considering renal function and kidney loading,right partial nephrectomy was performed first,followed by left nephroureterectomy with bladder cuff excision.At the 6-mo follow-up,no specific symptoms were reported and dialysis was not considered.There were no unusual findings in the imaging study,and regular follow-up and imaging studies are scheduled.CONCLUSION This case report assessed the feasibility of simultaneous minimal invasive robotic surgery as an alternative to conventional open or laparoscopic surgery.
