Single position with 4-hole laparoscopic radical nephrectomy and tumor thrombectomy for left renal cell carcinoma: a case report and review of the literature

Abstract

Background Venous tumor thrombus is one of the clinical features of progressive kidney cancer, causing a low 5-year survival rate. The current best treatment method is still complete resection of renal and venous tumor thrombus through surgery, which can effectively improve the prognosis of patients. The mainstream surgical methods include open surgery and minimally invasive surgery, but most of them require intraoperative position change to achieve the purpose of complete resection of venous tumor thrombus. Case presentation A 54-year-old woman was found to have a left kidney tumor by accident. Further examination showed that the left renal vein was invaded, and the inferior vena cava had not invaded. The patient had no clinical symptoms, and no obvious abdominal mass was found on physical examination. The surgery was performed using a single position, 4-hole transabdominal laparoscopic technique. The patient recovered well after the operation and was discharged from the hospital 4 days later. The postoperative pathology was: clear cell carcinoma grade III with hemorrhagic necrosis. We prescribed oral sorafenib mesylate tablets 400mg/day after discharge. After 6 months of follow-up, there was no recurrence or metastasis, and the patient recovered well. Conclusion Single position with 4-hole laparoscopic radical nephrectomy and tumor thrombectomy is safe and feasible for low-grade venous tumor thrombus. It has the advantages of simple operation steps, less trauma, quick postoperative recovery, fewer complications, worthing clinical application, and promotion.