Intraoperative ultrasound navigation in minimally invasive organ-preserving treatment of renal cell carcinoma of a transplanted kidney

Background. Organ-preserving minimally invasive techniques in the treatment of renal parenchymal cancer have now taken a leading position in modern oncology. Intraoperative ultrasound provides navigation in case of intraparenchymal formations of the renal parenchyma of small size. The use of this technique for laparoscopic resection of one's own kidneys is widespread; to date, however, there are no data on the use of intraoperative ultrasound for resection of a kidney graft with a tumor in the world. It should be noted that more than 1,500 kidney transplantations are performed annually in the Russian Federation and the incidence of renal cell carcinoma (RCC) of a transplanted kidney is about 0.5%. Kidney transplant patients have two-fold risk of developing neoplasms compared to the general population, and despite the low incidence in this group, such patients require a non-standard approach from clinicians and represent a difficult clinical case.

Objective. Evaluation of the possibility of using intraoperative ultrasound diagnostics in laparoscopic resection of a kidney graft with a tumor.

Material and methods. 22 patients underwent laparoscopic resection of a transplanted kidney with a tumor at the City Clinical Hospital № 52 from 2016 to 2022. 15 lesions were determined intraparenchymally and were detected only with intraoperative ultrasound.

Results. All patients underwent laparoscopic resection of a transplanted kidney with a tumor using intraoperative ultrasound navigation. There was no bleeding or death.

Conclusion. Intraoperative ultrasound navigation made it possible to identify and visualize intraparenchymal renal graft formations during laparoscopic resection of a transplanted kidney with a tumor. The use of this instrumental diagnostic method in the era of nephron-sparing treatment methods is certainly justified and makes it possible to reduce the volume and duration of the surgery.