With Liang Xixiang, male, 48 years old, Guangdong Shunde people, because of the long-term water right right renal pelvis stones, waist and abdomen distending pain for 3 months in 2011-12-26 in Guangdong No.2 People's Hospital, hospital before the District People's Hospital of Shunde, the First Affiliated Hospital of Zhongshan Medical University, the diagnosis of 1 right renal pelvic carcinoma with inferior vena cava tumor thrombus in the right kidney 2 stone and product concentrated "clear, and inform the operation risk is great, no chance of surgery.
Physical examination: T:36 degrees, P:107 / min, Bp:104/74mmHg, cachexia, anemia, right kidney, right abdomen, reach the size of about 10*6cm mass, unclear boundary, poor activity, percussion pain (+), improve the relevant examination after admission, blood WBC13.2*109, HGB92.9g/L, CT in water by the pelvic stones, severe, giant tumor of the right kidney, right renal vein and inferior vena cava tumor thrombus, right renal hilum, head of pancreas, multiple retroperitoneal lymph node metastasis, admitted to improve the inspection, to correct anemia, hypoproteinemia after.
A professor in the Department of Urology director Yang Guosheng presided, invited all department discussion, after the discussion agreed that the operation is extremely difficult, but the chance of operation, active preoperative preparation, in director Yang Guosheng's team, combined with cardiothoracic surgery in multidisciplinary collaboration, 2012-01-11 intubation general anesthesia right renal pelvis cancer resection, huge retroperitoneal tumor resection of inferior vena cava resection and artificial vascular replacement, the operation went smoothly, resection of the tumor size is about 20*20*12cm, the postoperative recovery in good condition.
1, long-term kidney stones, causing severe hydronephrosis of the right kidney, and ultimately lead to gallstones induced squamous cell carcinoma of the renal pelvis, is the main cause of the disease. Kidney stones caused by renal pelvic cancer is rare, so often patients do not pay attention to think of a small stone, not a serious illness, resulting in a huge renal pelvic tumor. This case is very rare.
2, the patient has a wide range of tumor invasion, especially the invasion of the inferior vena cava, life is always dangerous. Renal cancer with tumor thrombus in the inferior vena cava or invading inferior vena cava need renal tumor radical resection, tumor thrombus in the inferior vena cava, inferior vena cava resection and artificial removal of inferior vena cava replacement is the highest risk, the most difficult operation in Department of Urology, Department of general surgery, and cardiothoracic surgery, Interventional Radiology Association for many patients, after a number of hospital visits, were told the surgery is difficult, no chance of surgery. The successful treatment of this case shows that the treatment of patients with severe opportunities, do not give up any chance to save lives.