Minimally Invasive Surgery-Based Multidisciplinary Clinical Management of Reninoma: A Single-Center Study
Kan Liu, Baojun Wang, Xin Ma, Hongzhao Li, Yu Zhang, Jinlong Li, Yuanxin Yao, Lu Tang, Yundong Xuan, Aitao Guo, Xu Zhang
(Department of Urology, State Key Laboratory of Kidney Diseases, Chinese People’s Liberation Army (PLA) General Hospital/Chinese PLA Medical Academy, Beijing, China (mainland))
Med Sci Monit 2019; 25:1600-1610
This article presents our experience in managing a rare kidney tumor – reninoma – by analyzing a relatively large series of cases from a single center.
MATERIAL AND METHODS: Nine cases of reninoma were reviewed. Clinical manifestations, imaging examinations, laboratory examinations, perioperative data, and pathological findings were summarized. A 58.8-month follow-up was performed to evaluate patient survival and recrudescence.
RESULTS: The main clinical manifestations were hypertension, hypokalemia, headache, dizziness, nausea, vomiting, palpation, and sweating. Three patients had hypertensive end-organ damage, including brain hemorrhage, gestation termination, and grade III ocular fundus changes. All patients underwent retroperitoneal laparoscopic partial nephrectomy successfully. The mean warm ischemic time was 23.4 min. The median operation time was 95.1 min, with a median estimated blood loss of 60 ml. The median hospital stay was 6 days. No serious intraoperative or postoperative complications occurred. The histology and electron microscopy findings confirmed the diagnosis of reninoma in all cases. After 58.8 months of follow-up, symptoms involving hypertension were relieved in all patients, and no tumor recurrence or metastasis was detected.
CONCLUSIONS: Reninoma may have severe consequences despite being a benign tumor. Retroperitoneal laparoscopic partial nephrectomy is a feasible and effective method for the surgical removal of reninoma. Multidisciplinary cooperation plays an important role in improving the diagnosis and enabling the early surgical treatment of reninoma. Especially in cases of reninoma with moderate and high RENAL scores, an accurate diagnosis of reninoma based on multidisciplinary cooperation facilitates the selection of less invasive surgical approaches.
Keywords: Case Management, Renin, Surgical Procedures, Minimally Invasive