title: Hand-assisted laparoscopic radical nephrectomy in pregnancy.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Urology, Péterfy Sándor Hospital, Péterfy Sándor Str. 8-20, Budapest, 1074, Hungary, domjanzsoltdr70@gmail.com.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Domján
authors.forename: Endre
authors.initials: E
authors.lastname: Holman
authors.forename: Noémi
authors.initials: N
authors.lastname: Bordás
authors.forename: Alexander Stephan
authors.initials: AS
authors.lastname: Dákay
authors.forename: Kiarash
authors.initials: K
authors.lastname: Bahrehmand
authors.forename: István
authors.initials: I
authors.lastname: Buzogány
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D058733:Hand-Assisted Laparoscopy; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D009392:Nephrectomy / Q000379:methods*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*