PURPOSE: To demonstrate the beneficial results of hand-assisted laparoscopic tumor nephrectomy in pregnancy and to emphasize the proper timing of such surgery for its crucial importance attempting to avoid fatal cancer-related outcomes as a result of late interventions of aggressive tumors.
METHODS: A report of a 32-year-old woman with a 61 × 41 mm chromophobe renal cell carcinoma (RCC) successfully treated with laparoscopic transperitoneal hand-assisted nephrectomy during the 20th week of gestation is presented.
RESULTS: The fetus was stable during the intervention; the postoperative period was uneventful; she had a normal vaginal delivery at term and gave birth to a healthy female child. The patient remained tumor-free at her 34-month follow-up.
CONCLUSION: Although the pure laparoscopic interventions have become recognized in the treatment of RCC over the last decade, these methods have their limitations and dangers as well. The hand-assistance method makes the procedure faster and safer which is especially important during second or third trimester. Renal biopsy may play a specifically important role in predicting the malignant potential of a renal tumor, whereas postponement of this surgery until after delivery, may lead to the mother's death. To our knowledge, this is the first report on hand-assisted laparoscopic nephrectomy in pregnancy.
Written by:
Domján Z, Holman E, Bordás N, Dákay AS, Bahrehmand K, Buzogány I. Are you the author?
Department of Urology, Péterfy Sándor Hospital, Péterfy Sándor Str. 8-20, Budapest, 1074, Hungary.
Reference: Int Urol Nephrol. 2014 May 7. Epub ahead of print.
doi: 10.1007/s11255-014-0726-x
PubMed Abstract
PMID: 24800881
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