The application of nephron-sparing surgery in giant renal angiomyolipoma and its relevant surgical experience
10.3760/cma.j.issn.1000-6702.2018.05.007
- VernacularTitle:巨大肾血管平滑肌脂肪瘤行保留肾单位的适应证和手术经验
- Author:
Qiang ZHAO
1
;
Erkun DUO
;
Yong YANG
;
Peng DU
;
Yudong CAO
;
Shuo WANG
;
Jia LIU
;
Xingxing TANG
;
Yongpeng JI
;
Ning ZHANG
Author Information
1. 恶性肿瘤发病机制及转化研究教育部重点实验室北京大学肿瘤医院暨北京市肿瘤防治研究所泌尿外科
- Keywords:
Giant;
Renal;
Angiomyolipoma;
Nephron-sparing surgery
- From:
Chinese Journal of Urology
2018;39(5):347-350
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the application of nephron-sparing surgery in giant renal angiomyolipomas with the maximum diameter greater than 15 cm and its relevant surgical experience.Methods Between July 2014 to January 2017,5 patients with giant renal angiomyolipoma greater than 15 cm was admitted to our hospital for nephron-sparing surgery.The patients were all female ranging in age from 32-50 years (43.0 ± 7.1) years.According to the tumor imaging characteristics,we divided them into 3 different types including diffuse endogenous,exogenous and mixed type.All the tumors meet the criterion of exogenous type,ranging in diameter from 15.0-28.0 cm (20.4 ± 5.8) cm.4 patients harbored one single tumor and the other bilateral tumors.All the giant tumors located on the right side.Open transperitoneal nephron-sparing surgery was performed.Result During the operation,to find the joint site between the tumor and normal kidney is the key procedure in order to reserve more normal renal parenchyma.The operation time ranged from 105-175 min (125.4 ± 28.4) min,warm ischemia time 8-20 min (15.8 ±4.8) min,blood loss 50-400 ml (162.0 ± 141.5) ml.The average postoperative drainage volume ranged from 50-165 ml (99 ± 45) ml,the time of drainage tube removal 1-8 days (4.0 ± 2.6) days.The postoperative serum creatinine had no significant change compared to the value before operation (P =0.808).Postoperative hospital stay was 5-12 days (7.2 ± 2.9) days.Benign renal angiomyolipoma with negative margins was diagnosed as expected.No patient had a recurrence after a 1-32 months follow-up.Conclusion Nephron-sparing surgery could be used selectively in patients with giant renal angiomyolipoma greater than 15cm.For the tumors with the characteristic of exogenous type on imaging assessment before operation,open transperitoneal nephron-sparing surgery was an optional choice and could be implemented safely.
