RARE COMPLICAION AFTER NEPHRON-SPARING SURGERY IN COMPLEX PT3A KIDNEY CANCER PATIENTS: A CASE REPORT

Pavel  Yakovlev; Sofiia  Nikolaienko; Nataliia  Zokhniuk; Sergii  Pasiechnikov

doi:10.32345/USMYJ.3(108).2018.38-41

Pavel Yakovlev Bogomolets National Medical University, Kyiv, Ukraine
Sofiia Nikolaienko Bogomolets National Medical University, Kyiv, Ukraine
Nataliia Zokhniuk Bogomolets National Medical University, Kyiv, Ukraine
Sergii Pasiechnikov Bogomolets National Medical University, Kyiv, Ukraine

DOI: https://doi.org/10.32345/USMYJ.3(108).2018.38-41

Keywords: kidney cancer, renal artery-renal pelvis fistula, rare post-operative complication

Abstract

Benefit of partial nephrectomy compered to radical nephrectomy have shown by numerous studies as this preserves most of the functioning kidney, thus preventing onset of chronic kidney failure and potential cardio-vascular mortality. In the same time, partial nephrectomy is associated with slightly increase in the rates of post-operative complications such as perioperative bleeding and urinary fistulas which might lead to life-threatening conditions. This case shows surgery, which was performed for 39 year-old male patient with intraparenchymal kidney cancer and the postoperative course, complicated with rare vascular abnormality – renal artery-renal pelvis fistula. It demonstrates multidisciplinary oncourosurgical and endovascular approach of treating kidney cancer lesions that may provide successful organ-preserving results. The possibility of such complication in centrally localized tumors should be taken into account.

References

Lai, T. C., Ma, W. K, & Yiu, M. K. (2016). Partial nephrectomy for T1 renal cancer can achieve an equivalent oncological outcome to radical nephrectomy with better renal preservation: the way to go. Hong Kong Medical Journal.

Van Poppel, H, Da Pozzo, L., Albrecht, W., Matveev, V, Bono, A., Borkowski, A., ... & Marreaud, S. (2011). A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. European urology, 59(4), 543—552.

Jeldres, C., Patard, J. J., Capitanio, U, Perrotte, P, Suardi, N., Crepel, M., ... & Pfister, C. (2009). Partial versus radical nephrectomy in patients with adverse clinical or pathologic characteristics. Urology, 13(6), 1300-1305.

Mitchell, R. E., Gilbert, S. M., Murphy, A. M., Olsson, C. A., Benson, M. C., & McKiernan, J. M. (2006). Partial nephrectomy and radical nephrectomy offer similar cancer outcomes in renal cortical tumors 4 cm or larger. Urology, 61(2), 260—264.

Go, A. S., Chertow, G. M., Fan, D., McCulloch, С. E, & Hsu, C. Y. (2004). Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. New England Journal of Medicine, 351(73/ 1296-1305.

Zini, L., Perrotte, P, Capitanio, U, Jeldres, C., Shariat, S. F, Antebi, E., ... & Karakiewicz, P. I. (2009). Radical versus partial nephrectomy: effect on overall and noncancer mortality. Cancer: Interdisciplinary International Journal of the American Cancer Society, 115(7), 1465-1471.

Klatte, T, Ficarra, V, Gratzke, C., Kaouk, J., Kutikov, A., Macchi, V, ... & Russo, P. (2015). A literature review of renal surgical anatomy and surgical strategies for partial nephrectomy. European urology, 6%(6), 980-992.

Stephenson, A. J., Hakimi, A. A., Snyder, M. E., & Russo, P. (2004). Complications of radical and partial nephrectomy in a large contemporary cohort. The Journal of urology, 171(7/ 130—134.

Lesage, K, Joniau, S., Fransis, K, & Van Poppel, H. (2007). Comparison between open partial and radical nephrectomy for renaltumours: perioperative outcome and health-related quality of life. european urology, 51(3), 614—620.

Albani, J. M., & Novick, A. C. (2003). Renal artery pseudoaneurysm after partial nephrectomy: three case reports and a literature review. Urology, 62(2), 227—231.

Polascik, T. J., Pound, C. R., Meng, M. V., Partin, A. W., & Fray, F. (1995). Partial nephrectomy: technique complications and pathological findings. The Journal of urology, 154(4), 1312-1318.

Kundu, S. D., Thompson, R. H, Kallingal, G. J., Cambareri, G., & Russo, P. (2010). Urinary fistulae after partial nephrectomy. В JU international, 106(7), 1042-1044.

Kutikov, A., & Uzzo, R. G. (2009). The RENAL nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. The Journal of urology, 182(3/ 844—853.

Ljungberg, B., Bensalah, K, Canfield, S., Dabestani, S., Hofmann, F, Hora, M., ... & Mulders, P. (2015). EAU guidelines on renal cell carcinoma: 2014 update. European urology, 67(5), 913—924.

Jung, S., Min, G. E., Chung, В. I., & Jeon, S. H. (2014). Risk factors for postoperative hemorrhage after partial nephrectomy. Korean journal of urology, 5 5 (1), 17-22.

Fergany, A. F, Hafez, K. S., & Novick, A. C. (2000). Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10- year followup. The Journal of urology, 163(2), 442—445.

Maurice, M. J., Zhu, H, Kim, S., & Abouassaly, R. (2016). Survival after partial and radical nephrectomy for high-risk disease: A propensity- matched comparison. Canadian Urological Association Journal, 10(9— 10), E282.

Breau, R. H, Crispen, P. L., Jimenez, R. E., Lohse, С. M., Blute, M. L., & Leibovich, В. C. (2010). Outcome of stage T2 or greater renal cell cancer treated with partial nephrectomy. The Journal of urology, 183(3), 903-908.

Venyo, A. K, & Shah, S. (2008). Lower Polar Aberrant Renal Vein—Renal Pelvis Fistula: A Rare Cause of Haematuria. West African journal of medicine, 27(4).

Gbneyli, S., Gyk, M., Bozkaya, H, Зэпаг, C., Tizro, A., Korkmaz, M., ... & Oran, Э. (2015). Endovascular management of iatrogenic renal arterial lesions and clinical outcomes. Diagnostic and Interventional Radiology, 21(3), 229.

Nohara, T, Matsuyama, S., Kawaguchi, S., Miyagi, T, Seto, C., & Mochizuki, K. (2016). Usefulness of selective renal artery embolization for urinary fistula following partial nephrectomy: Two case reports. Molecular and clinical oncology, 5(1), 158—160.

Zhu, Y., Liu, Y., Zhang, J., & Lin, Z. (2014). Risk evaluation of selective renal arterial embolization in the treatment of delayed hemorrhage from renal artery pseudoaneurysm after partial nephrectomy. Cell biochemistry and biophysics, 70(3), 1833—1839.