University of Wisconsin-Madison, Madison, WI, USA.
Curr Urol Rep. 2013 Apr;14(2):147-53. doi: 10.1007/s11934-013-0311-3.
Renal angiomyolipomas (AMLs) are benign renal masses that are often asymptomatic and detected incidentally. However, treatment might be necessary in symptomatic presentations or when the mass exceeds 4 cm in size. While the goal of management for renal AMLs is to relieve symptoms and prevent hemorrhage, a priority is renal function preservation, especially given the propensity of these lesions to recur. The traditional treatment for renal AMLs is renal angioembolization or surgical excision of the lesion. With advancements in minimally invasive surgery, several other modalities have now emerged for nephron sparing approaches. These include angioembolization, laparoscopic and percutaneous ablative therapies such as radiofrequency ablation, cryoablation and microwave ablation, and pure or robot-assisted laparoscopic partial nephrectomy. Given the relatively low frequency of renal AMLs requiring treatment, much of the available literature on these minimally invasive approaches is largely extrapolative, based on series on small renal masses, i.e. renal cell carcinoma (RCC). This report is based on a thorough review of the published literature to date on the minimally invasive treatment and outcomes of renal AMLs.
肾血管平滑肌脂肪瘤(AMLs)是良性的肾肿瘤,通常无症状,是偶然发现的。然而,在有症状表现或肿瘤大小超过 4cm 时,可能需要治疗。虽然肾血管平滑肌脂肪瘤的治疗目标是缓解症状和预防出血,但优先考虑的是保护肾功能,特别是考虑到这些病变有复发的倾向。肾血管平滑肌脂肪瘤的传统治疗方法是肾血管栓塞或手术切除病变。随着微创技术的进步,现在已经出现了几种保肾的方法。这些方法包括血管栓塞、腹腔镜和经皮消融治疗,如射频消融、冷冻消融和微波消融,以及纯腹腔镜或机器人辅助部分肾切除术。鉴于需要治疗的肾血管平滑肌脂肪瘤相对较少,因此这些微创方法的大部分可用文献主要是基于小的肾肿瘤(即肾细胞癌)的系列研究的外推。本报告基于对目前关于肾血管平滑肌脂肪瘤的微创治疗和结果的文献的全面回顾。