Super-Selective Artery Embolization before Laparoscopic Partial Nephrectomy in Treating Renal Angiomyolipoma

Abstract

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.

Robot-Assisted versus Laparoscopic Partial Nephrectomy for Giant Sporadic Renal Angiomyolipomas of ≥7 cm: A Propensity Score-Matched Analysis

“…However, to date, whether or not using NSS directly after SAE in treating AMLs differs in efficacy has not been demonstrated. One study [36] that included only 36 patients concluded that the application of SAE before LPN can decrease the difficulty of the surgery, the complications, and the risk of rebleeding. Additional studies are needed to provide evidence.…”

Experiencia de embolización de la arteria renal previa a nefrectomía

“…Las opiniones sobre el papel de la EAR preoperatoria en el manejo de pacientes con patología tumoral renal aún son controvertidas, 5 sin poder hallar en la literatura un consenso sobre los beneficios y morbilidad asociados con el procedimiento. 9-11 A pesar de que se ha descrito la facilitación de la nefrectomía a través de la disminución de la pérdida de sangre, la facilidad de disección secundaria al edema en los planos tisulares y la disminución de los tiempos quirúrgicos con la EAR, 2,12 en el presente estudio se observó tendencia a mayor volumen de sangrado intraoperatorio y necesidad de transfusión en aquellos pacientes sometidos a embolización previa a la nefrectomía.…”

A case of acute bleeding from a small, asymptomatic renal angiomyolipoma (AML) during pneumoperitoneum induction for a rectal tumor resulting in acute hematuria and anemia

“…reported a study investigating the possibility of super-selective artery embolization of AML before partial nephrectomy in order to reduce morbidity and mortality during resection, especially for diameter >7 cm. 4 In our approach the patient underwent super-selective artery embolization in order to successfully treat acute bleeding, as the clinical practice suggests. 5 With our approach, 3 days after embolization she was able to complete a laparoscopic low anterior resection with primary re-anastomosis without any complications.…”