Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2022; 10(12): 3886-3892
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3886
Successful robot-assisted partial nephrectomy for giant renal hilum angiomyolipoma through the retroperitoneal approach: A case report
Shu-Hang Luo, Qin-Song Zeng, Jun-Xing Chen, Bin Huang, Zong-Ren Wang, Wen-Ji Li, Yun Yang, Ling-Wu Chen
Shu-Hang Luo, Qin-Song Zeng, Jun-Xing Chen, Bin Huang, Zong-Ren Wang, Ling-Wu Chen, Department of Urology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
Wen-Ji Li, Yun Yang, Department of Anesthesiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
Author contributions: Luo SH and Zeng QS contributed equally to this work; All authors have read and approve the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ling-Wu Chen, MD, PhD, Chief Doctor, Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhong Shan 2nd Road, Guangzhou 510080, Guangdong Province, China. chenlwu@mail.sysu.edu.cn
Received: September 11, 2021
Peer-review started: September 11, 2021
First decision: October 25, 2021
Revised: November 1, 2021
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: April 26, 2022
Abstract
BACKGROUND

Giant renal angiomyolipomas (AMLs) may lead to complications including flank pain, hematuria, hypertension, retroperitoneal hemorrhage and even death. Giant AMLs which grow around renal hilar vessels and the ureter are rare. Most previous reports on the treatment of giant renal AMLs have focused on open surgery or a transperitoneal approach, with few studies on the retroperitoneal approach for large AMLs. We here report a case of giant renal hilum AML successfully treated with robot-assisted laparoscopic nephron sparing surgery the retroperitoneal approach, with a one-year follow-up.

CASE SUMMARY

A 34-year-old female patient was diagnosed with renal AML 11 years ago and showed no discomfort. The tumor gradually increased in size to a giant AML over the years, which measured 63 mm × 47 mm ×90 mm and was wrapped around the right hilum. Therefore, a robotic laparoscopic partial nephrectomy (LPN) via the retroperitoneal approach was performed. The patient had no serious postoperative complications and was discharged soon after the operation. At the one-year follow-up, the patient's right kidney had recovered well.

CONCLUSION

Despite insufficient operating space via the retroperitoneal approach, LPN for giant central renal AMLs can be completed using a well-designed procedure with the assistance of a robotic system.

Keywords: Renal angiomyolipoma, Robotic laparoscopic surgery, Retroperitoneal approach, Laparoscopic aspiration, Case report

Core Tip: Renal angiomyolipoma (AML) is an infrequent benign tumor, and treatment includes open surgery or a transperitoneal laparoscopic nephrectomy (LPN). Despite several disadvantages, the retroperitoneal (RP) approach enables direct access to the renal artery and does not require bowel mobilization, which may avoid gastrointestinal complications and shorten recovery time. We report a patient with renal AML who underwent successful robot-assisted LPN using the RP approach. The patient was discharged from hospital on the 4th postoperative day and one-year follow-up showed no recurrence. This case highlights the feasibility of RP LPN with a well-designed surgical procedure, and the advantages of this method outweigh the disadvantages in AML patients.