Peritoneal Dialysis and Retroperitoneal Laparoscopic Radical Nephrectomy: A Favorable Experience With a Patient Complicated by Renal Cell Carcinoma

Abstract

Peritoneal dialysis (PD) is an accepted modality for managing end-stage kidney disease. We herein report a 75-year-old female patient on chronic PD who was complicated by renal cell carcinoma. She was successfully treated with retroperitoneal laparoscopic radical nephrectomy followed by a prompt resumption of the procedure. Various surgeries disturbing the abdominal wall integrity often disrupt the regular PD schedule, and using minimally invasive approaches is therefore an attractive therapeutic option. Our experience emphasizes the feasibility and safety of a retroperitoneal approach–based laparoscopic technique based on several empirical examples. However, systemic studies on this topic are obviously lacking, so we strongly recommend the accumulation of more cases similar to our own. Several surgical concerns that need to be dealt with among PD patients are also discussed.

Peritoneal Dialysis and Malignancy: An Experience With a Patient Complicated by Gastric Carcinoma

“… 16 , 17 , 19 However, this may otherwise be a matter of concern, especially in patients on PD, as an intervention that disturbs the integrity of the abdominal cavity boundaries would disrupt the regular PD schedule. 20 , 21 Nevertheless, we should bear in mind that the procedure can be successfully reinstituted, even after gastric resection. 22 …”

When end‐stage kidney disease complicates abdominal surgery

“…In the past, laparoscopic transperitoneal nephrectomy was followed by suspension of PD for 10‐14 days 89 . A retroperitoneal approach might obviate the need for suspending PD during the postoperative period, as reported by Hsu et al 85 Regardless of the approach, there exists a risk of incisional hernias and dialysate leak when PD resumption occurs shortly after nephrectomy, but this appears to be a rare finding 86–88 …”

“…Nephrectomy may be indicated in PD patients for suspicious renal masses, confirmed renal cell carcinoma, or polycystic kidney disease 84–88 . Additionally, bilateral nephrectomy may be warranted in certain patients, resulting in immediate ESKD and the need for dialysis.…”