医学
肾切除术
栓塞
外科
围手术期
肾功能
氰基丙烯酸酯
放射科
回顾性队列研究
并发症
肾
内科学
胶粘剂
有机化学
化学
图层(电子)
作者
Jaeseung Shin,Kichang Han,Joon Ho Kwon,Gyoung Min Kim,Doyoung Kim,Seung Chul Han,Hee Joon Kim,Jong Yun Won,Man Deuk Kim,Do Yun Lee
标识
DOI:10.1016/j.juro.2018.10.022
摘要
We evaluated the safety and clinical efficacy of transarterial embolization of vascular complications after partial nephrectomy.This retrospective study included 1,187 patients who underwent partial nephrectomy between January 2006 and December 2017. A total of 36 patients were referred to the interventional radiology department for vascular complications after partial nephrectomy. Data on demographics, clinical manifestations, angiographic findings, the embolization procedure, perioperative details, and technical and clinical success rates were analyzed. Further, renal function was recorded at diagnosis, after embolization and at the last followup.Hemorrhage was diagnosed a median of 5 days (range 0 to 89) postoperatively. The incidence of requiring embolization due to hemorrhage after laparoscopic surgery (5.9% or 17 of 289 cases) was higher than that after open surgery (1.8% or 8 of 440, p = 0.003) and robot-assisted surgery (2.4% or 11 of 458, p = 0.014). The technical and clinical success rates were 100% (36 of 36 patients) and 94.4% (34 of 36) with 2 patients requiring additional embolization with n-butyl-2-cyanoacrylate glue. The mean ± SD estimated glomerular filtration rate at diagnosis, after embolization and at last followup was 81.0 ± 21.6, 83.7 ± 21.0 and 84.9 ± 15.8 ml/minute/1.73 m2, respectively (p = 0.345). No major complication was observed during followup.Transarterial embolization is safe and effective for managing vascular complications after partial nephrectomy. Moreover, renal function was well preserved with super selective transarterial embolization.
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