肾癌外科根治性切除术前经动脉插管栓塞的临床价值

目的：探讨不同栓塞方法对肾癌外科根治性切除术前经动脉插管栓塞的临床价值。方法回顾性分析经手术病理证实的肾癌患者43例,分为 A 组(同时成功栓塞患侧肾动脉及肾包膜动脉、肾上腺动脉)、B 组(仅栓塞患侧肾动脉)、C 组(直接行外科根治性切除)。比较3组患者的手术时间、手术难易程度、术中出血量、病灶切除成功率、术后生存率。结果A、B 组与 C 组比较其手术时间、手术难易程度、术中出血量度、病灶切除成功率及术后生存率差异均有统计学意义(P <0.01),A、B 两组间比较除病灶切除成功率外其余指标差异有统计学意义(P <0.01)。结论肾癌外科根治性切除术前辅助性动脉栓塞治疗效果好,尤其以彻底栓塞病变侧肾动脉、包膜动脉等血供者效果更佳。

The value of transcatheter arterial embolization before radical nephrectomy in treatment of renal carcinoma

Objective To explore the clinical value of different transcatheter arterial embolization methods for renal carcino-ma before radical nephrectomy.Methods The related data of 43 patients with renal carcinoma who were confirmed by surgical pa-thology were retrospectively analyzed.Renal artery,renal capsular artery and adrenal artery of lesion side kidney were super-selec-tive embolized before surgery was set as group A,while Lesion side renal artery embolized was set as group B.Direct surgical radical nephrectomy was set as group C.The related data of operation time,ease or complexity of operation,intraoperative blood loss,suc-cess rate of lesion resection and postoperative survival rate were analyzed and compared in the three groups with statistical meth-ods.Results There were significant differences among the three groups in the average operation time,ease or complexity of opera-tion,intraoperative blood loss,success rate of lesion resection and postoperative survival rate (P < 0.01 ).There were significant differences between group A and B about all indexes except success rate of lesion resection(P <0.01).Conclusion The cases with additional transcatheter arterial embolization before radical nephrectomy improved obviously,especially in the cases who underwent completely embolization of lesion side renal artery and renal capsular artery.