Laparoscopic nephron-sparing surgery in the management of angiomyolipoma: a single center experience
| Autor: | Lambda P. Msezane, Mark H. Katz, Sergey Shikanov, Tom Deklaj, David A. Lifshitz, Arieh L. Shalhav, Anthony Chang |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Angiomyolipoma Radiofrequency ablation Urology medicine.medical_treatment Single Center Nephrectomy Perioperative Care law.invention law hemic and lymphatic diseases medicine Humans Embolization Demography business.industry Nephrons Middle Aged medicine.disease Surgery Concomitant Cohort Female Laparoscopy Nephron sparing surgery business |
| Zdroj: | Journal of endourology. 24(4) |
| ISSN: | 1557-900X |
| Popis: | Angioembolization is often the first-line treatment for patients with renal angiomyolipoma (AML). Regrowth and repeated hemorrhage after embolization, however, remain a concern. Laparoscopic partial nephrectomy (LPN) is the definitive, minimally invasive treatment alternative. We compared the outcomes of LPN in patients who had a diagnosis of AML with patients with other renal tumors.From a prospective LPN database, we identified patients with a final pathologic diagnosis of AML (group 1). The ability of preoperative imaging to predict AML final pathology results was studied. Surgical and postoperative outcomes in group 1 were compared with the outcomes of the rest of our LPN cohort (group 2).Of 184 LPNs that were performed between 2002 and 2008, 14 (7.6%) patients and 15 renal units had a diagnosis of AML. Two patients underwent concomitant LPN and radiofrequency ablation (RFA) for multiple AML lesions. In group 1, only 33% of the patients had a preoperative diagnosis of AML. There were no significant differences in tumor size, age, preoperative estimated creatinine clearance, body mass index, and comorbidities between the groups. The mean estimated blood loss in groups 1 and 2 was 214 mL and 178 mL, respectively (P = 0.5). The complication rates were similar between the groups. With a median follow-up of 15 months, no AML recurrences or bleeding was observed in group 1.The results of LPN or RFA, when appropriate, in AML patients are comparable to the results of LPN for other renal tumors. The preoperative imaging studies were a poor predictor of AML in patients who were undergoing LPN. |
| Databáze: | OpenAIRE |
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