The Application Of Emergency Renal Artery Embolization Combined With Laparoscopic Resection Or Open Operation In The Treatment Of Acute Renal Hamartoma Ruptured

Objective To investigate the application of preoperative emergency renal artery embolization combined with laparoscopic resection or open operation in the treatment of acute renal hamartoma ruptured.Methods:collect45patients with Acute renal hematoma ruptured from November,2006 to November,2017.underwent Renal hamartoma resection.In these cases,there were 21cases of selective arterial embolization combined with Laparoscopic resection or open operation for renal hamartoma?embolization group?,and 24 cases of direct emergency open operation?non-embolization group?,Comparison of two groups with nephrectomy ratio,operation time,intraoperative blood loss,the time of postoperative abdominal cavity drainage tube,hospitalization days,Complication rate,postoperative 3 months self-reflection rise of serum creatinine,glomerular filtration rate estimation value loss rate.[Results]:The nephron-sparing rate of the embolization group was 90.5%?19/21?compared with 25%?6/24?of the non-embolization group?x2=19.446,p=0.001?.The blood volume of the embolization group?127.9±24.1?was less than that of the non-embolization group?769.4±189.3?ml?t=-16.454 p=0.020?;The operation time of the embolization group?119.4±5.2?was significantly shorter than that of the non-embolization group?135.5±3.3?min?t=-12.669,P=0.021?.The length of hospitalization days in the embolization group?7.3±0.5?d was significantly shorter than that in the non-embolization group?10.8±0.7?d?t=-18.596,P=0.044?.The removal of intraperitoneal drain tube time?4.5±0.6?d was significantly shorter than that in the non-embolization group?6.7±0.5?d?t=-13.492,P=0.031?,the complication rate in the embolization group9.5%?2/21?was significantly lower than that in the non-embolization group 37.5%?4/24??t=4.746,P=0.029?.postoperative 3months self-reflection rise of serum creatinine of the embolization group?19.8±2.1??mol/L was significantly lower than that of the non-embolization group?58.7±5.3??mol/L?t=-33.418,P=0.001?.The glomerular filtration rate estimation value loss rate?18.9±4.3?ml·min^-1·1.73 m^-2 was significantly lower than that of the non-embolization group?53.8±7.8?ml·min^-1·1.73 m^-2,?t=-18.782,p=0.045?.No evidence of recurrence was found during follow-up period in both groups.[Conclusions]:preoperative emergency renal artery embolization combined with Laparoscopic resection or open operation in the treatment of acute renal hamartoma is better than that direct emergency open operation.with shortening operation time,reducing intraoperative hemorrhage,can remove the abdominal drainage tube earlier,reduce postoperative complications.