Retroperitoneal laparoscopic partial nephrectomy for treatment of metanephric adenoma (Report of 6 cases)

Abstract

Objectives: To investigate the clinical and pathological features of metanephric adenoma (MA) and the clinical outcome after retroperitoneal laparoscopic nephron-sparing surgery.Methods: Six out of 183 partial nephrectomies performed during January 2009 to August 2014 were confirmed to be MA confirmed by postoperative pathological study. Perioperative parameters of the six patients were then retrospectively collected, analyzed and compared with current literature, including warm ischemia time (WIT), total operation time, estimated blood loss (EBL), positive surgical margin (PSM), and complications. Surgical and oncological outcome of all six patients were evaluated based on a mean follow up of 17 months (5-48 months).Results: Tumors in all six cases were all successfully removed by partial nephrectomy. Mean WIT was 24.7 min (19-35 min). Mean operation time was 103.6 min (82-147 min). Mean EBL was 53.5 ml (20-85 ml). No conversion, transfusion or other major complication were observed in all six cases. Postoperative pathology confirmed negative surgical margin in all six cases. During a mean of 17 month follow up (5-48 months), no local recurrence or metastasis were found in all six cases.Conclusion: MA is a rare benign primary kidney epithelial cancer, which could hardly be differentiated from renal malignancies based on preoperative imaging. Our data suggested that retroperitoneal laparoscopic partial nephrectomy can be used for surgical treatment of MA, in terms of tumor control and preservation of renal function.

Robot‐assisted versus laparoscopic partial nephrectomy for anatomically complex T1b renal tumors with a RENAL nephrometry score ≥7: A propensity score‐based analysis

“…The treatment assignment in our retrospectively designed study was usually at the discretion of the highly experienced surgeons according to tumor and patient characteristics. The existing studies had presented the detailed procedures of LPN and RPN …”

Retroperitoneal laparoscopic partial nephrectomy for metanephric adenoma in a pediatric patient - The first case report from vietnam

“… 4 , 5 Compared to total nephrectomy, RLPN is considered to be a better option for improving postoperative survival and similar long-term survival outcomes. 6 Moreover, the retroperitoneal laparoscopic approach has several benefits, including a more comfortable recovery, shorter hospital stays, reduced hospital costs, better cosmetic results, and a lower risk of small bowel obstructions.…”

“…In any of these scenarios, whether T1 RCC, MA, or WT, RLPN offers a feasible option, preserving kidney tissue and function for the patient. 5 , 6 , 7 Typically, in Vietnam, similar cases are managed with radical nephrectomy due to limited experience. However, based on current evidence and the expertise of highly experienced surgeons, we decided to treat our patient with RLPN.…”

Chemotherapy Combined With Surgery in a Case With Metanephric Adenoma

“…Barroca et al ( 24 ) believes that immunohistochemical and molecular studies are still needed to confirm the diagnosis of MA even if the cellular needle biopsy specimen suggests a diagnosis of MA. Since MA is considered by most scholars to be a benign lesion, the surgical method is gradually changing from nephrectomy to nephron-sparing surgery ( 5 , 25 , 26 ). Although most scholars consider MA to be a benign lesion, cases with metastasis or with malignant changes have been reported ( 27 – 29 ).…”