腹腔镜部分肾切除术治疗肾血管平滑肌脂肪瘤前的超选择性动脉栓塞术
Super-Selective Artery Embolization before Laparoscopic Partial Nephrectomy in Treating Renal Angiomyolipoma.
作者信息
Qin Chao, Wang YiChun, Li Pengchao, Li Pu, Tao Jun, Shao Pengfei, Lv Qiang
机构信息
Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
出版信息
Urol Int. 2017;99(3):277-282. doi: 10.1159/000472261. Epub 2017 Apr 14.
INTRODUCTION
To investigate the feasibility and efficiency of super-selective artery embolization (SAE) before laparoscopic partial nephrectomy (LPN) in treating renal angiomyolipoma (RAML).
MATERIALS AND METHODS
A retrospective analysis was conducted on 36 consecutive patients who underwent SAE before LPN (group A, n = 16) or LPN directly (group B, n = 20) from June 2010 to March 2016. Intraoperative blood loss, blood transfusion, operation time, warm ischemia time (WIT), and prognosis were compared between groups.
RESULTS
SAE before LPN decreased operating time, intraoperative blood loss and WIT (p < 0.05), and improved postoperative renal function (p < 0.001). Complications in group B included intraoperative blood loss of 4 patients and postoperative hematuria of 2 patients who recovered a few days later. No complications were observed in group A. In the follow-up of 3 months, a patient in group B formatted retroperitoneal hematoma without any symptoms and received expectant treatment.
CONCLUSIONS
The application of SAE before LPN can decrease the difficulty of the surgery, the complications, and the risk of rebleeding and RAMLs recurrence.
引言
探讨腹腔镜部分肾切除术（LPN）前超选择性动脉栓塞术（SAE）治疗肾血管平滑肌脂肪瘤（RAML）的可行性和有效性。
材料与方法
回顾性分析2010年6月至2016年3月期间连续36例行LPN前SAE（A组，n = 16）或直接行LPN（B组，n = 20）的患者。比较两组患者的术中出血量、输血量、手术时间、热缺血时间（WIT）及预后情况。
结果
LPN前SAE可缩短手术时间、减少术中出血量及WIT（p < 0.05），并改善术后肾功能（p < 0.001）。B组并发症包括4例术中出血及2例术后血尿，均在数日后恢复。A组未观察到并发症。随访3个月时，B组1例患者形成无症状腹膜后血肿，接受保守治疗。
结论
LPN前应用SAE可降低手术难度、减少并发症及再出血和RAML复发风险。
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