60-year-old Grandma Wang was born with only one left kidney and a huge tumor of nearly 15cm; If her kidney is removed, she will be on dialysis for the rest of her life. Recently, the urology team of the East Hospital of Wuhan University People's Hospital rose to the challenge and successfully removed the tumor for Grandma Wang, preserving this precious single kidney.
In January this year, when Grandma Wang went to the hospital for examination due to back pain, she unexpectedly found that she was congenitally congenital with only one left kidney and a right deficiency (also called the left lone kidney), and the left kidney contained a huge tumor of nearly 15cm. Grandma Wang resisted lifelong dialysis, and with a strong desire to save her kidney, she sought medical treatment from Professor Zhu Hengcheng, director of the Department of Urology of the East Branch of the People's Hospital of Wuhan University.
Combined with the results of blood test indexes, urinary CTU and other related examinations, Professor Zhu Hengcheng found that the tumor was located in the upper pole and middle of the left kidney, exceeding the hilar artery and vein. If partial nephrectomy is performed, the tumor must be completely and completely removed, otherwise the tumor is prone to **; At the same time, it cannot damage the arteries and veins, and it is necessary to preserve as much of the renal parenchyma as possible, which is extremely difficult to operate.
Even so, because the kidney is too small after surgery, there is still the possibility of dialysis, and ** nephrectomy is routinely required, but in view of Grandma Wang's strong desire to preserve the kidney, Professor Zhu Hengcheng's team discussed with Meng Qingtao, director of the Department of Anesthesiology of the Eastern Hospital, and decided to take the first plan of partial abdominal renal resection to face the difficulties.
During the operation, under the escort of the anesthesia team led by Director Meng Qingtao, Professor Zhu Hengcheng's team carefully separated the left kidney and the tumor, blocked the renal pedicle, quickly and accurately resected the tumor along the edge of the tumor, sutured the renal calyces and renal parenchyma in three layers, and completely preserved the normal kidney tissue and blood vessels of the lower and middle poles of the kidney, so as to preserve the first-line "kidney" machine for Grandma Wang.
The operation was completed in only one and a half hours, and the renal pedicle was only blocked for 20 minutes, and the blood was very small. After the careful care of Zeng Yan's long-term nursing team after the operation, Grandma Wang's postoperative creatinine was 190mmol l and the urine output was 1300ml. The postoperative pathological result was clear cell renal carcinoma, and dialysis was not required after discharge.
Professor Zhu Hengcheng introduced that kidney cancer often exists in the form of a "silent killer", which generally has no obvious symptoms in the early stage of the disease and is often found in physical examination. If the "kidney cancer triad" – low back pain, hematuria and an abdominal mass – appears early – it often indicates a relatively late course of the disease. Early detection of kidney cancer less than 4 cm is the best indication for partial nephrectomy, and the postoperative effect is similar to that of ** nephrectomy; If the tumor is larger than 10 cm, kidney-sparing surgery is significantly more difficult, and the likelihood of postoperative surgery is also increased.
Professor Zhu Hengcheng reminded that people with a family history of kidney cancer should have regular B-ultrasound or CT examinations every year, in order to achieve "early detection, early diagnosis, and early diagnosis."
Reporter: Summer Correspondent: Liu Yu.
Editor: Wang Jian.
Editor-in-charge: Summer.
Editor: Wang Jun.