Open Radical Nephrectomy for Suspected Renal Malignancy–Tips and Tricks

Abstract Objective To present the surgical approach to a cystic renal mass suspicious for malignancy in a 22 month old female. Materials The patient was a healthy female was found to have an abdominal mass by her parents. Her mother underwent a nephrectomy as a child for unknown pathology. Physical exam was otherwise unremarkable and laboratory workup was normal. Imaging workup revealed a large cystic renal mass suspicious for malignancy. Surgical resection was planned. Results A non-syndromic 22 month old female underwent open radical nephrectomy on the left with regional lymph node dissection. A transverse abdominal incision was used, followed by medial reflection of the colon and complete renal mobilization. The distal ureter and renal vasculature were identified and controlled and the kidney removed. A retractor was then assembled and regional lymph node dissection performed. Final pathology was cystic nephroma with 10 benign lymph nodes. The patient recovered well and was discharged home 3 days after surgery. Conclusions Open radical nephrectomy is an important part of protocol management for patients with renal masses suspicious for malignancy.