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52 year old patient suffering from a rare kidney cancer successfully treated at Fortis Hospital, Bannerghatta Road

A 52-year-old chef suffering from rare cancer in a Horseshoe Kidney was successfully treated at Fortis Hospital, Bannerghatta Road by a team of doctors led by Dr Mohan Keshavamurthy, Director Urology, Uro-Oncology, Andrology, Transplant & Robotic Surgery, Fortis Hospital, Bangalore & Dr Sreeharsha Harinatha, Consultant – Urology & Robotic surgery, Fortis Hospital, Bannerghatta Road.

Horseshoe kidney is a rare congenital development of the kidney, also known as renal fusion where both the kidneys join together in the lower pole to form a U- shape at the bottom. The patient who is a chef by profession had arrived at the hospital with chief complaints of hematuria ie, presence of blood in the urine. He had a history of hypertension, diabetes mellitus, and had undergone angioplasty for ischemic heart disease a month back. Hence, the cardiologist had put him on a blood-thinning medicine, which was stopped only 36 hours
prior to the surgery.

"Horseshoe kidney is a uncommon congenital condition with incidence 1 per 400-600 live births. 0.25% of these anomalous kidneys develop cancer. This patient had developed cancer in the kidney, due to which he was experiencing blood in his urine. Post thorough examination, we suggested him to undergo robotic-assisted right hemi-nephrectomy of the horseshoe kidney.Heminephrectomy is generally conducted for patients who often have a problem known as a duplex kidney with nonfunction of one moiety."  said Dr Mohan Keshavamurthy, Director Urology, Uro-Oncology, Andrology, Transplant &Robotic Surgery, Fortis Hospital, Bangalore, said

The treatment of localized cancer in a horseshoe kidney is challenging due to the unique anatomical features. When performing Robotic-assisted partial nephrectomy for renal cell
carcinoma (Kidney cancer), especially in a horseshoe kidney, preoperative imaging is crucial for identifying the location of the multiple & anomalous blood vessels supplying the kidney.
Hence, CT renal angiogram with 3D reconstruction was done to clearly delineate the vessels. Also, intra-operative use of Robotic firefly technology and ultrasound helps in precise
delineation of tumor margin and sparing maximum nephron mass especially in a diabetic patient, informed Dr Sreeharsha Harinatha, Consultant – Urology &; Robotic surgery, Fortis
Hospital, Bannerghatta Road.

Postoperative creatinine at 6 months is a powerful predictor of quality and quantity of life. Hence, the maximal preservation of nephron mass is essential. No blood transfusion was required and the blood-thinning medicine was restarted after 24 hours and the patient was discharged on the third postoperative day.

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