右肾包膜动脉化疗栓塞在原发性肝癌介入治疗中的安全性及有效性研究

目的右肾包膜动脉参与原发性肝癌供血发生率低，既往文献报道少。本研究回顾性分析其临床特点及影像学资料，并探究右肾包膜动脉化疗栓塞在原发性肝癌患者中的有效性及安全性。 方法2016年5月至2019年12月，共纳入13例右肾包膜动脉参与原发性肝癌供血病例，观察并分析其影像学资料、右肾包膜动脉造影及参与肿瘤供血特点、化疗栓塞术后并发症以及近期疗效。 结果患者肿瘤大小为2.4～15.6 cm，平均8.0±4.25 cm。所有患者肿瘤均位于Ⅴ、Ⅵ、Ⅶ段中一段或两段，其中，69.2%（9/13）患者肿瘤压迫或紧贴右肾。10例患者仅由肾包膜上动脉供血，2例患者仅由肾包膜中动脉供血，1例患者同时由肾包膜上动脉、中动脉供血，无肾包膜下动脉供血病例。术后1个月及3个月局部控制率分别为92.3%、84.6%。 结论对于肝肿瘤位于右后叶且肿瘤负荷较大时，可常规行右侧膈下动脉及右肾包膜动脉造影，明确是否参与肿瘤供血。右肾包膜动脉化疗栓塞安全有效，近期疗效确切。

The safety and effect of transcatheter-arterial chemoembolization for primary hepatic carcinoma fed by right renal capsular artery

ObjectiveThe incidence of right renal capsular artery participating in primary hepatic carcinoma blood supply is low, and there are few previous reports in the literature. This study retrospectively analyzed its clinical characteristics and imaging data, explored the effectiveness and safety of transcatheter-arterial chemoembolization for primary hepatic carcinoma fed by right renal capsular artery. MethodsFrom May 2016 to December 2019, a total of 13 cases which primary hepatic carcinoma fed by right renal capsular artery were enrolled. We evaluate the clinical characteristics and imaging data, features of right renal capsular artery angiography and tumor blood supply, complications and the short-term effects. ResultsThe tumor size of the patients was ranged 2.4 cm to 15.6 cm, average 8.0±4.25 cm. All tumors were located in one or two of the Ⅴ, Ⅵ, and Ⅶ segments. Among them, 69.2% (9/13) of the patients had tumor compression or abutment to the right kidney. Ten patients were only supplied by the superior capsular artery, 2 patients were provided by the middle capsular artery only, and one patient was supplied by both the superior and middle capsular artery. The present study did not contain cases in which the inferior capsular artery supplied tumors. The local control rates at 1 month and 3 month were 92.3% and 84.6%, respectively. ConclusionsFor liver tumors located in the right posterior lobe and the tumor burden is large, routine angiography of the inferior right phrenic artery and right renal capsular artery can determine whether it provide blood for the tumor. Transcatheter-arterial chemoembolization for primacy hepatic carcinoma fed by right renal capsular artery is safe and effective, and the short-term effect is promising.