Effect of superselective branch renal artery embolization combined with zeroischemic laparoscopic partial nephrectomy on postoperative renal function in patients with stage T1 renal cancer
Objective To investigate the safety of digital subtraction technique (DSA) combined with zero-ischemic laparoscopic partial nephrectomy(LPN)in the treatment of stage T1 renal tumors and its effect on renal function.Methods From May 2017 to April 2020,a total of 39 patients who underwent retroperitoneal LPN for T1 renal tumors in our hospital. DSA superselective target artery embolization was performed at the interventional operating room 1~12 hours before laparoscopic partial nephrectomy with zero ischemia. The patients′operation time, intraoperative blood loss, postoperative gastrointestinal function recovery time, postoperative hospitalization time and so on were analyzed, compared preoperative 24 h and postoperative 24 h, 7 d, 30 d blood urea nitrogen (BUN), blood creatinine (Scr) level, at the same time, the patient′s preoperative and postoperative 6 months of glomerular filtration rate (GFR) results were analyzed.Results All the operations were completed successfully. The intraoperative operation time was (123.2 ± 7.6) min. The intraoperative blood loss was (108.5±66.3) mL, and the recovery time of gastrointestinal function was (2.5 ±0.6) d, the postoperative hospital stay was (7.6±1.5) d, There was no statistical differences in Scr and BUN before and after operation(all P>0.05).The GFR of renal patients 6 months after operation was (45.6±8.4) mL/min, which was significantly lower than that before operation (59.0±9.5) mL/min, and the difference was statistically significant (P<0.001). The postoperative GFR of healthy side kidney was (68.6±11.5) mL/min, which was higher than that of preoperative (63.3±10.5) mL/min, but the difference was not statistically significant (P=0.204). The follow-up was 12 to 36 months, and no tumor recurrence or metastasis was found.Conclusions Superselective renal artery embolization combined with zero ischemia LPN is safe and feasible in the treatment of T1 stage renal cell carcinoma patients.