Effectiveness and safety of laparoscopic enucleation combined with selective arterial embolization for renal angiomyolipoma.

Abstract

This study aims to investigate the clinical value of laparoscopic enucleation combined with selective arterial embolization for the treatment of renal angiomyolipoma. Data of patients who underwent laparoscopic nephron-sparing surgery for renal angiomyolipoma between July 2013 and November 2014 in our center were analyzed. Before surgery, 19 patients underwent selective arterial embolization, while 24 patients did not receive this treatment. Intraoperative blood loss was 46.4 ± 20.6 ml in the embolization group and 89.5 ± 30.4 ml in the non-embolization group (P= 0.000). Operation time was 90.3 ± 21.1 minutes in the embolization group and 131.7 ± 18.6 minutes in the non-embolization group (P= 0.000). Warm ischemia time was 9.5 ± 5.7 minutes in the embolization group and 24.2 ± 4.8 minutes in the non-embolization group (P= 0.001). Hospitalization time was 7.7 ± 1.1 days in the embolization group and 6.3 ± 1.3 days in the non-embolization group (P= 0.000). No serious complications occurred in patients in the embolization group, while one patient developed urinary leakage and another patient had angiomyolipoma in the operation area in the non-embolization group. Three months after the operation, serum creatinine level was 70.1 ± 13.7 μ mol/L in the embolization group and 84.2 ± 9.1 μ mol/L in the non-embolization group (P= 0.000). No tumor recurrence occurred in patients in both groups. Compared with laparoscopic partial nephrectomy alone, tumor enucleation combined with selective arterial embolization can reduce blood loss and shorten warm ischemia time.