Bakal C W, Cynamon J, Lakritz P S, Sprayregen S
Department of Radiology, Albert Einstein College of Medicine, Bronx, New York.
J Vasc Interv Radiol. 1993 Nov-Dec;4(6):727-31. doi: 10.1016/s1051-0443(93)71958-2.
The authors evaluated the effectiveness of preoperative ethanol renal artery embolization in reducing transfusion requirements during nephrectomy for renal cell carcinoma.
Of 93 consecutive patients who underwent nephrectomy for renal cell carcinoma from 1980 to 1990, 24 patients underwent embolization within 24 hours of nephrectomy. Finding in this group were compared with those in 69 control patients who underwent surgery without preoperative embolization.
Embolized tumors were larger than nonembolized ones (mean volume, 595 vs 257 mL) (P < .05). Patients with large hypervascular tumors (volume over 250 mL) who underwent complete embolization received significantly smaller mean blood transfusion volumes than control patients (250 vs 800 mL; P = .01). The transfusion volume associated with incomplete embolization was higher than that associated with no embolization.
Complete alcohol embolization significantly reduces the volume of blood transfused during nephrectomy for large hypervascular renal cell carcinomas, and incomplete embolization is associated with larger transfusions. Preoperative embolization must be complete and should be performed more widely.
作者评估术前乙醇肾动脉栓塞术在减少肾细胞癌肾切除术期间输血需求方面的有效性。
在1980年至1990年间连续接受肾细胞癌肾切除术的93例患者中，24例在肾切除术前24小时内接受了栓塞术。将该组患者的结果与69例未进行术前栓塞术而接受手术的对照患者的结果进行比较。
栓塞的肿瘤比未栓塞的肿瘤大（平均体积，595对257 mL）（P <.05）。接受完全栓塞的大血管丰富肿瘤（体积超过250 mL）患者的平均输血量明显低于对照患者（250对800 mL；P =.01）。与不完全栓塞相关的输血量高于与未栓塞相关的输血量。
完全酒精栓塞术可显著减少大血管丰富的肾细胞癌肾切除术期间的输血量，不完全栓塞与更多输血相关。术前栓塞必须完全，并且应更广泛地进行。
