THẬN Ứ NƯỚC KHỔNG LỒ: BÁO CÁO CA LÂM SÀNG VÀ TỔNG QUAN Y VĂN

Abstract

Introduction: A giant hydronephrosis is defined as the adult’s renal pelvis containing more than 1 liter of urine, or at least 1.5% of the body weight. The commonest cause of giant hydronephrosis in adults is congenital ureteropelvic junction obstruction. We report a clinical case of giant hydronephrosis nephrosis containing more than 13 liters of fluid that was successfully removed using retroperitoneal laparoscopic nephrectomy. Case presentation: A 52-year-old male with a medical history of large abdominal girth since childhood was accidentally discovered left giant hydronephrosis. On the computed tomography scan image, a large dilated left kidney containing a lot of fluid measuring 27 x 27 x 36cm occupied most of the abdominal cavity. In fact, a total of 13 liters of fluid was drained from the renal pelvis. The patient underwent laparoscopic retroperitoneal simple nephrectomy with good results: operating time was 110 minutes; estimated blood loss was 50ml, the length of hospital stay after surgery was 4 days and an uneventful following-up time of 1 month. Discussion: Historically, the accurate diagnosis rate of giant hydronephrosis was less than 50%. Contrast enhanced computed tomography is considered the gold standard for diagnosis of giant hydronephrosis. The main treatment for giant hydronephrosis is nephrectomy with preoperative renal drainage to decompress because the kidneys are often lost function and there is a risk of dysplasia in the renal parenchyma as well as the urinary tract. Conclusion: For very large giant hydronephrosis kidneys (containing >5 liters of fluid, especially containing > 10 liters of fluid), laparoscopic surgery is feasible depending on specific cases. However, the main approach is still open surgery.