The Efficacy Comparative Analysis Of Short-term Outcomes Between Selective Arterial Embolization And Retroperitoneal Laparoscopic Surgery For Complex Renal Angiomyolipoma

Objective:Make a study to compare the clinical efficacy of the selective arterial embolization and retroperitoneal laparospic enucleation in the treatment of complex renal angiomyolipoma.Methods:The clinical data were reviewed and analyzed between 28 patients who underwent selective arterial embolization(SAE)and 24 patients who underwent retroperitoneal laparospic enucleation(RLE)in the First Affiliated Hospital of Nanchang University from October 2012 to October 2017.All of the 76 patients' discharge diagnosis were renal angiomyolipoma with spontaneous rupture or the imaging data showed renal multiple angiomyolipoma or the ttumor size > 8cm.The differences in age,sex,tumor size and site,operative time,length of stay,perioperative complication rate,reoperation rate,reduction of tumor size and hospitalization cost between the two groups were compared.Results:There was no significant difference in age,sex,tumor size and site,preoperative creatinine,preoperative hemoglobin,bleeding,double kidney multiple in group SAE and group RLE(P > 0.05).There was a comparability among the two groups.The two groups were all successful,the operation time(49.4 + 7.4VS195.0 + 90.6min,P < 0.05),the days of lying in bed after operation were(3.2 + 2.3VS6.3 + 1.7,P < 0.05),the number of cases of postoperative creatinine transient increase(3.5%VS25%,P=0.024),postoperative analgesic dosage(20.1 + 11.8VS120.0 + 18.9,P < 0.05),postoperative complications(21%VS50%,P=0.031),hospital days(6.5+5.4VS7.9 + 1.9,P=0.012),hospitalization expenses(19026.8+7410.6VS27642.1+8952.9,P<0.05)were statistically significant(P<0.05).The incidence of reoperation(7.1%VS0%,P=0.182)during the follow-up period.Two groups of patients were followed up for 3-36 months.2 patients in group SAE underwent reoperation during the follow-up period.No operation was performed in group RLE.In group SAE,the tumor volume in all patients within 8-30 months decreased by 4.5cm compared with that before embolization.No tumor recurrence was found in group RLE.Conclusion:For complex renal angiomyolipoma which had spontaneous rupture or bilateral multiple angiomyolipoma or tumor size > 8cm,the selective arterial embolization had minimally invasive,quicker recovery,shorter hospitalization stay after operation,the more protection of renal functionand,and less postoperative complications than retroperitoneal laparospic enucleation.For complex renal hamartoma,selective arterial embolization is a minimally invasive,safe and effective treatment.