Zargar Homayoun, Addison Ben, McCall John, Bartlett Adam, Buckley Brendan, Rice Michael
Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.
ANZ J Surg. 2014 Jul-Aug;84(7-8):564-7. doi: 10.1111/ans.12545. Epub 2014 Feb 18.
To assess the outcomes of patients undergoing percutaneous renal artery embolization (PRAE) prior to radical nephrectomy.
We performed retrospective chart review of patients undergoing PRAE in Auckland Public Hospital from January 2004 to December 2011. PRAE was performed under epidural anaesthesia and within 24 h of nephrectomy. We compared our perioperative outcomes with the published literature.
Forty-two patients were identified in this series. Patients had predominantly more advanced stage disease with 30 (71%) being T3 or higher (TNM staging). Median operation time was 192 min (range 84-428). 45.2% of patients experienced complications from the surgery. There were no complications associated with PRAE.
PRAE prior to nephrectomy is a safe procedure. There is no convincing evidence in the literature that the benefits outweigh the risks. All published studies are non-randomized and subject to selection bias, so the true role of PRAE has not yet been determined and routine use is probably not justified.
评估在根治性肾切除术前行经皮肾动脉栓塞术（PRAE）患者的预后。
我们对2004年1月至2011年12月在奥克兰公立医院接受PRAE的患者进行了回顾性病历审查。PRAE在硬膜外麻醉下进行，且在肾切除术24小时内完成。我们将围手术期结果与已发表的文献进行了比较。
本系列共纳入42例患者。患者主要为疾病分期较晚，30例（71%）为T3期或更高分期（TNM分期）。中位手术时间为192分钟（范围84 - 428分钟）。45.2%的患者经历了手术并发症。未发生与PRAE相关的并发症。
肾切除术前行PRAE是一种安全的手术。文献中没有令人信服的证据表明其益处大于风险。所有已发表的研究均为非随机研究且存在选择偏倚，因此PRAE的真正作用尚未确定，常规使用可能不合理。
