Introduction: Horseshoe kidney (HK) is a rare congenital renal anomaly characterized by the fusion of both kidneys along the midline. This article reviews diagnostic strategies and current therapeutic options for renal tumors in HK, highlighting anatomical particularities and advances in surgical management.
Materials and Methods: Three male patients (aged 51, 65, and 72 years), all diagnosed with horseshoe kidney and localized renal tumor, were included. In all three cases, computed tomography with 3D reconstruction was performed for anatomical assessment and surgical planning. Laparoscopic partial nephrectomy with selective arterial clamping was carried out, recording surgical times, blood loss, warm ischemia time, and postoperative course. All cases were managed at a single center, the Hospital Alemán in Buenos Aires
Results: Tumor sizes ranged from 4 to 7.4 cm (RENAL Score between 4 and 9). Surgical time varied between 180 and 250 minutes, and warm ischemia time between 42 and 50 minutes. Intraoperative blood loss ranged from 300 to 600 ml. Negative margins were achieved in all cases. Two patients had no complications or recurrence during follow-up. One patient (pT1b, G2) developed recurrence at 13 months.
Conclusion: The laparoscopic approach has gained prominence in recent years due to its advantages of less invasiveness and faster recovery, achieving greater nephron preservation in complex cases determined by anatomical alterations. However, the choice of surgical approach should be individualized, considering the anatomical characteristics of the horseshoe kidney and the clinical conditions of the patient.
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