[Combined application of 2 micron microwave resection and laparoscopy in treatment of urinary tumor in patients after renal transplantation].
OBJECTIVE
To reduce the negative intervention for the transplant kidney and explore the optimal operational method for treating urinary tumor in patients after renal transplantation.


METHODS
From March 2006 to March 2013, a total of 12 post renal transplantation patients with renal pelvis tumor/ureter tumor underwent operations. After the general anesthesia, the patient was placed in lithotomy position. The 2 micron microwave resection was performed, with the ureteral orifice as the center. After the ureteral wall section was resected, the resection was forwarded 6 cm. Then the patient was placed in lateral position. The laparoscopic radical nephrectomy was performed, and when this procedure was completed, the laparoscopy was converted to the other side to observe to the bladder side. Meanwhile, the operator pulled the ureter and maintained some tension, using the ultrasound knife to dissect the adjacent tissue and avoiding injuring the transplant kidney. With this method, the resected distal ureter and partial bladder were resected en bloc. In some condition, the uerteral tumor was tightly connected to the adjacent tissue, and the upper ureter failed to be removed completely, a short incision could be performed besides the musculus rectus abdominis. The Foley catheter had remained for 2 weeks after the operation.


RESULTS
The 12 operations were successfully performed. The operation duration ranged from 110 to 290 minutes, and the bleeding volume was from 50 to 200 mL. Only one female patient developed secondary bleeding 18 hours after the operation, however, the secondary operation successfully stopped the bleeding. The mean hospital stay was 10.5 days.


CONCLUSIONS
The combination use of 2 micron microwave resection and laparoscopy in the treatment of urinary tumor in patients after renal transplantation is effective, and has its advantages: lowering the risk of damaging the transplant kidney and easing the operation. Furthermore, this procedure is minimally invasive and safe. The patient could recover soon.
Department of Urology, Peking University People's Hospital, Beijing 100034, China.
Xing-ke
XK
Qu
Xiao-feng
XF
Wang
Xiao-bo
XB
Huang
Xiao-dan
XD
Li
Xiao-wei
XW
Zhang
D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D016030:Kidney Transplantation; D010535:Laparoscopy; D008872:Microwaves; D009392:Nephrectomy; D014513:Ureter / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery; D013520:Urologic Surgical Procedures