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논문 기본 정보

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학술저널
저자정보
Ragheed Saoud (The University of Chicago Medicine) Nassib Abou Heidar (The American University of Beirut Medical Center) Joshua Aizen (The University of Chicago Medicine) Ciro Andolfi (The University of Chicago Medicine) Logan Galansky (The University of Chicago) Osmanuddin Ahmed (The University of Chicago Medicine) Arieh L. Shalhav (The University of Chicago Medicine)
저널정보
대한비뇨기과학회 Investigative and Clinical Urology Investigative and Clinical Urology Vol.62 No.3
발행연도
2021.1
수록면
267 - 273 (7page)

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Purpose: Partial nephrectomy is associated with a 1%–2% risk of renal iatrogenic vascular lesion (IVL) that are commonly treated with selective angioembolization (SAE). The theoretical advantage of SAE is preservation of renal parenchyma by targeting only the bleeding portion of the kidney. Our study aims to assess the long-term effect of SAE on renal function, especially that this intervention requires potentially nephrotoxic contrast load injection. Materials and Methods: A retrospective review of patients undergoing partial nephrectomy between 2002 and 2018 was performed, and patients who developed IVL were identified. A 1:4 matched case-control analysis was performed. Paired t-test and χ2 test were used for continuous and categorical variables, respectively. Multivariable logistic and Cox proportional hazards regression analyses were used to identify risk factors and confounders for SAE and postoperative renal function. Results: Eighteen patients found to have an IVL after partial nephrectomy were matched with 72 control patients. IVL's were more common in patients after minimally invasive partial nephrectomy (89% vs. 70%, p=0.008) and in those with higher RENAL nephrometry scores (8.8±2.0 vs. 6.5±1.8, p<0.001). On multivariable analysis, lower RENAL scores proved to decrease the odds of requiring postoperative SAE. No significant difference in renal function outcomes was seen at 24 months of follow-up after surgery. Conclusions: SAE for the management of IVL following partial nephrectomy is a safe and efficient procedure with no significant impact on short or long-term renal function. Less complex renal tumors with lower RENAL scores are less likely to require postoperative SAE.
#Embolization #Kidney function tests #Nephrectomy #Postoperative period

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참고문헌 (26)

참고문헌 신청
Siegel R / 2014 / Cancer statistics, 2014 / CA Cancer J Clin 64:9~29 google schola 황의창 / 2013 / Small Renal Masses: Surgery or Surveillance / Investigative and Clinical Urology 54(5):283~288 dbpia Capitanio U / 2015 / Nephron-sparing techniques independently decrease the risk of cardiovascular events relative to radical nephrectomy in patients with a T1a-T1b renal mass and normal preoperative renal function / Eur Urol 67:683~689 google schola MacLennan S / 2012 / Systematic review of perioperative and quality-of-life outcomes following surgical management of localised renal cancer / Eur Urol 62:1097~1117 google schola Hyams ES / 2011 / Iatrogenic vascular lesions after minimally invasive partial nephrectomy : a multi-institutional study of clinical and renal functional outcomes / Urology 78:820~826 google schola

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