CAJ | 학술논문

目的：探讨选择性肾动脉栓塞联合腹腔镜肾部分切除术治疗肾错构瘤自发性破裂的安全性和有效性。方法回顾性总结分析本院2009年1月至2014年8月收治的23例肾错构瘤自发性破裂的临床诊治资料，肿瘤直径平均5.5cm。腹腔镜肾部分切除术于肿瘤靶标血管栓塞后24～72小时实施，观察手术时间、术中出血量、术中术后并发症及术后住院时间等。结果腹腔镜手术均获成功，手术时间平均123分钟，术中出血量平均90ml，术后住院时间平均9.2天。2例术后出现尿瘘，保守治愈后出院。术后肾功能无明显受损，无其他严重并发症出现。随访6个月至4年，未见肿瘤复发。结论选择性肾动脉栓塞联合腹腔镜肾部分切除术治疗临近肾错构瘤自发性破裂安全可行、创伤小，术者需具有熟练的腹腔镜技术，术前需充分准备。
목적：탐토선택성신동맥전새연합복강경신부분절제술치료신착구류자발성파렬적안전성화유효성。방법회고성총결분석본원2009년1월지2014년8월수치적23례신착구류자발성파렬적림상진치자료，종류직경평균5.5cm。복강경신부분절제술우종류파표혈관전새후24～72소시실시，관찰수술시간、술중출혈량、술중술후병발증급술후주원시간등。결과복강경수술균획성공，수술시간평균123분종，술중출혈량평균90ml，술후주원시간평균9.2천。2례술후출현뇨루，보수치유후출원。술후신공능무명현수손，무기타엄중병발증출현。수방6개월지4년，미견종류복발。결론선택성신동맥전새연합복강경신부분절제술치료림근신착구류자발성파렬안전가행、창상소，술자수구유숙련적복강경기술，술전수충분준비。
Objective To investigate the safety and feasibility of selective renal arterial embolization combined with laparoscopic partial nephrectomy in treatment of renal angiomyolipoma with spontaneous rupture.Method Retrospective analysis was conducted based on the clinical data of 23 cases of renal angiomyolipoma with spontaneous rupture from January 2009 to August 2014, and the mean tumor size of the patients was 5.5 cm. Retroperitoneal laparoscopic nephron-sparing surgery was performed 24~72h after selective renal artery embolization. The operative time, intraoperative blood loss, complications and hospital stay were analyzed.Result All the operations were performed successfully. No one required additional open surgery. The mean operating time and blood loss was 123min and 90 ml, respectively. The mean hospital stay was 9.2d. 2 cases suffered urinary fistula posteroperatively but recovered after conservative treatment. After the procedure, total renal function was normal and no other serious complications occurred. During the follow-up lasting for 6 months to 4 years, no tumor recurrence was found.Conclusion Selective renal arterial embolization combined with laparoscopic partial nephrectomy is feasible and safe for renal angiomyolipoma with spontaneous rupture in well selected and prepared patients by experienced operators.