{"title":"机器人辅助根治性肾切除术治疗先天性膈疝修补后右胸内肾肾细胞癌1例","authors":"Yutaro Sasaki, Saki Kobayashi, Fumiya Kadoriku, Kei Daizumoto, Ryotaro Tomida, Yoshito Kusuhara, Tomoya Fukawa, Kunihisa Yamaguchi, Yasuyo Yamamoto, Junya Furukawa","doi":"10.1002/iju5.70081","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Congenital diaphragmatic hernia (CDH) can result in intrathoracic displacement of the kidney, presenting anatomical challenges for robot-assisted radical nephrectomy (RARN). Reports of RARN in such cases are scarce.</p>\n </section>\n \n <section>\n \n <h3> Case Presentation</h3>\n \n <p>A 56-year-old man with a history of right-sided CDH repair was referred for evaluation of an incidentally discovered right renal mass. Computed tomography revealed two right renal tumors (cT1aN0M0) and cranial displacement of the kidney into the thoracic cavity. Given the possibility of intra-abdominal adhesions and the retrohepatic location of the kidney, retroperitoneal RARN was selected. An intercostal trocar was used to access the high-positioned kidney. The renal vessels were safely managed using a Vas Guide, and no complications occurred. Pathology confirmed clear cell renal cell carcinoma (pT1aN0M0).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>RARN can be safely performed in patients with prior CDH repair and intrathoracic renal displacement. Preoperative planning and alternative trocar strategies, such as intercostal placement, are essential for successful outcomes.</p>\n </section>\n </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"513-516"},"PeriodicalIF":0.0000,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70081","citationCount":"0","resultStr":"{\"title\":\"Robot-Assisted Radical Nephrectomy for Renal Cell Carcinoma in a Right Intrathoracic Kidney Following Congenital Diaphragmatic Hernia Repair: A Case Report\",\"authors\":\"Yutaro Sasaki, Saki Kobayashi, Fumiya Kadoriku, Kei Daizumoto, Ryotaro Tomida, Yoshito Kusuhara, Tomoya Fukawa, Kunihisa Yamaguchi, Yasuyo Yamamoto, Junya Furukawa\",\"doi\":\"10.1002/iju5.70081\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Congenital diaphragmatic hernia (CDH) can result in intrathoracic displacement of the kidney, presenting anatomical challenges for robot-assisted radical nephrectomy (RARN). Reports of RARN in such cases are scarce.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Case Presentation</h3>\\n \\n <p>A 56-year-old man with a history of right-sided CDH repair was referred for evaluation of an incidentally discovered right renal mass. Computed tomography revealed two right renal tumors (cT1aN0M0) and cranial displacement of the kidney into the thoracic cavity. Given the possibility of intra-abdominal adhesions and the retrohepatic location of the kidney, retroperitoneal RARN was selected. An intercostal trocar was used to access the high-positioned kidney. The renal vessels were safely managed using a Vas Guide, and no complications occurred. Pathology confirmed clear cell renal cell carcinoma (pT1aN0M0).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>RARN can be safely performed in patients with prior CDH repair and intrathoracic renal displacement. Preoperative planning and alternative trocar strategies, such as intercostal placement, are essential for successful outcomes.</p>\\n </section>\\n </div>\",\"PeriodicalId\":52909,\"journal\":{\"name\":\"IJU Case Reports\",\"volume\":\"8 5\",\"pages\":\"513-516\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-08-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70081\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IJU Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/iju5.70081\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IJU Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/iju5.70081","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Robot-Assisted Radical Nephrectomy for Renal Cell Carcinoma in a Right Intrathoracic Kidney Following Congenital Diaphragmatic Hernia Repair: A Case Report
Introduction
Congenital diaphragmatic hernia (CDH) can result in intrathoracic displacement of the kidney, presenting anatomical challenges for robot-assisted radical nephrectomy (RARN). Reports of RARN in such cases are scarce.
Case Presentation
A 56-year-old man with a history of right-sided CDH repair was referred for evaluation of an incidentally discovered right renal mass. Computed tomography revealed two right renal tumors (cT1aN0M0) and cranial displacement of the kidney into the thoracic cavity. Given the possibility of intra-abdominal adhesions and the retrohepatic location of the kidney, retroperitoneal RARN was selected. An intercostal trocar was used to access the high-positioned kidney. The renal vessels were safely managed using a Vas Guide, and no complications occurred. Pathology confirmed clear cell renal cell carcinoma (pT1aN0M0).
Conclusion
RARN can be safely performed in patients with prior CDH repair and intrathoracic renal displacement. Preoperative planning and alternative trocar strategies, such as intercostal placement, are essential for successful outcomes.
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