ABSTRACT
Anaplastic lymphoma kinase rearrangement-associated renal cell carcinoma (ALK-RCC) is a rare subtype of renal cell carcinoma characterized by genetic rearrangements involving the ALK gene. Managing ALK-RCC is challenging due to its rarity and limited treatment options. Targeted therapies directed at the ALK gene have shown promise. ALK-RCC is a rare subtype of renal cell carcinoma with unique clinical and pathological features. ALK inhibitors may hold promise as a targeted therapy for ALK-RCC. Further research is needed to understand the behavior of ALK-RCC and develop effective treatment strategies.
ABSTRACT
Introduction and Study Purpose: Renal pedicle control is a crucial period in laparoscopic donor nephrectomy (LDN). Till now, there is no standardized technique for renal pedicle control. Proper evaluation and investigation of the different ways of renal vessel control have to be done to avoid any calamitous event. We aim to prove the safety and reliability of the Hem-o-Lok clips for the renal vascular control in transperitoneal LDN. Methods: All LDNs or hand-assisted LDNs done between January 2016 and December 2018 were collected. The primary outcome was the safety of the Hem-o-Lok clips. The secondary outcomes were blood loss, ischemia time, hospital stay, cost, and operative time. The data were analyzed using SPSS 20, and a statistical package was conducted. Results: The data showed that 238 laparoscopic donor nephrectomies were done. The renal pedicle control during the 1st year was done using a vascular stapler for the artery (63 cases) and two polymer self-locking clips extra-large (XL) for the vein. Two events were reported in the form of mechanical failure. In the following 2 years, the artery was controlled using polymer self-locking clips large (L) few millimeters distal to the aorta and two metallic clips distal to it to increase the safety and stability of the vascular stump (175 cases). However, the vein was controlled by the two polymer self-locking clips XL. There was no reported intraoperative complications or events related to this way of pedicle control; there was no open conversion or blood transfusion required. There was no postoperative complication or collection in ultrasound. Conclusion: Using a combined polymer self-locking clip few millimeters distal to the aorta and two metallic clips distal to it for renal artery control in laparoscopic donor nephrectomies is cost-effective and safe. However, further and broader evidenced base studies are still needed to establish a standard technique for renal pedicle control.
ABSTRACT
A 44-year-old female presented to the urology clinic with flank pain and tenderness. After full assessment, the patient was booked for surgery for partial nephrectomy and the patient was diagnosed with renal cell carcinoma (RCC) chromophob type. Six months later, the patient came back for follow-up; a mass was detected on the same kidney. Radical nephrectomy was performed to excise what is thought to be a recurrence of RCC and the tissues were sent to pathology. The postoperative pathology report confirmed the presence of xanthogranulomatous pyelonephritis rather than RCC recurrence.