The benefit of preoperative renal artery embolization in patients with renal cell carcinoma and venous tumor thrombus
10.3760/cma.j.issn.1000-6702.2016.09.003
- VernacularTitle:肾癌伴静脉瘤栓术前肾动脉栓塞对手术的辅助作用
- Author:
Huajun ZHANG
;
Qi TANG
;
Shiying TANG
;
Lin YAO
;
Lin CAI
;
Xuesong LI
;
Zhisong HE
;
Liqun ZHOU
- Publication Type:Journal Article
- Keywords:
Renal artery embolization;
Renal cell carcinoma;
venous tumor thrombus
- From:
Chinese Journal of Urology
2016;37(9):652-654
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the impact of preoperative renal artery embolization in renal cell carcinoma patients with venous tumor thrombus.Methods A total of 249 RCC patients with venous tumor thrombus underwent radical nephrectomy and thrombectormy in our hospital.Seventy-four patients received preoperative renal artery embolization while other 175 patients did not.The related items were analyzed.The tumor thrombus level was divided into 5 groups with American Mayo clinic classification system.Considering the significant difference in tumor situation and treatment strategies, we took the hepatic vein as a cut-off line, dividing patients into two subgroups, the early and advanced tumor thrombus groups.There were 208 patients in the early tumor thrombus group and 41 patients in the advanced group.The related items were analyzed respectively.Results Patients in the embolization group tended to have larger tumors and higher percentage of advanced tumor thrombus.For all patients, the embolization group had longer operation time [(4.8 ±2.1) h vs.(4.1 ±2.2) h ,P <0.05] and greater median blood loss (900ml vs 500 ml,P <0.05), compared to the non-embolization patients, and RAE did not show benefits on perioperative outcomes seemingly.However, subgroup analysis of patients with advanced tumor thrombus ( above hepatic vein) , in spite of the larger size of tumor, preoperative RAE showed significant benefits on reducing operation time [(7.0 ±1.7)h vs.(8.2 ±1.8)h, P<0.05)] and intraoperative blood loss (2 000 ml vs.3 000 ml, P<0.05) and decreasing blood transfusion (1 525 ml vs.2 050 ml ,P>0.05).Conclusion Preoperative RAE may be more appropriate for patients with advanced tumor thrombus because of its benefits in reducing operation time, intraoperative blood loss and elevating the operative security.
