Comparison of retroperitoneal laparoscopic enucleation with selective renal arterial embolization (SAE) and NonSAE for renal angiomyolipoma

Abstract

Objective To compare the safty and clinical efficacy of retroperitoneal laparoscopic excision after selective arterial embolization (SAE) and nonSAE in renal angiomyolipoma. Methods The clinical data of 163 patients with renal angiomyolipoma received retroperitoneal laparoscopy were enrolled from January 2010 to December 2015 in our hospital. The patients were divided into retroperitoneal laparoscopic enucleation with selective arterial embolization group (SAE group, n=33) or tumor resection with renal arterial embolization group (non SAE group, n=130). Twenty seven cases were carried out frozen-section examination during operation. The differences of operative time, intra- and post-operation blood loss, length of hospitalization between the two groups were compared. Results All the patients underwent the operation successfully. Intraoperative bleeding (ml), operation time (min), postoperative length of stay (d) and cost (ten thousand yuan) of SAE group were: (41±13), (47±15), (3.50±0.24), (1.63±0.29); non SAE group were: (83±23), (103±22), (4.50±0.31), (1.23±0.35). Seven patients suffered postoperative hemorrhage and 3 were hemostasia with embolization. To compare the clinical efficacy, SAE group was slightly superior to non SAE with significant difference (P<0.05). Five cases (3.1%) were diagnosed with clear cell carcinoma by postoperative pathology. There was no significant difference in total renal function before and after operation. No tumor recurrence was observed during follow-up in two groups. Conclusions Retroperitoneal laparoscopic enucleation with selective arterial embolization in renal angiomyolipoma patients can reduce operation difficulty, shorten operation time, decrease the risk of intra- and post-operation bleeding, which can be apply in wconditional medical institutions. Key words: Renal angiomyolipoma; Arterial embolization; Retroperitoneal laparoscopic