Robot-Assisted Partial Nephrectomy for Renal Pelvic Urothelial Carcinoma Complicated with Renal Insufficiency: A Case Report

Background Primary malignant tumors of the renal pelvis are relatively few in urinary tumors, with a high degree of malignancy and a relatively poor prognosis. Most of the pathological results are urothelial carcinoma. The standard surgical operation is full-length resection of the kidney and ureter and sleeve resection of the bladder. However, for patients with renal insufficiency or solitary kidney, clinicians find it terribly difficult to make the decision on the surgical resection and protection of the renal function. A patient with renal pelvis malignant tumor complicated with renal insufficiency was treated in our hospital.Case presentation: A 77-year-old Chinese female with a more than 5-year history of renal dysfunction,was hospitalized due to "painless gross hematuria found for 4 months". The patient had no other significant discomfort. CT discovered that the volume of both kidneys is small, and the soft tissue density shadow was exactly at the right ureteropelvic junction. Therefore we consider the diagnosis was tumor of right renal pelvis. Patient did not accept radical surgical resection and was required to preserve the kidney. So the patient underwent robot-assisted partial nephrectomy for right renal pelvic , and the operation was successful. After surgery chemotherapy drugs were instilled into the renal pelvis through a single J-tube infusion. During nearly three years of follow-up, the patient regularly reviewed ureteroscopy and MRI/CT, no significant abnormalities were seen. Postoperative creatinine control was better and no hemodialysis was performed. The curative effect is acceptable.Conclusions Partial nephrectomy for renal pelvic is also an option for patients with malignant tumor of renal pelvis who need to preserve their kidneys.