Yıl: 2020 Cilt: 19 Sayı: 2 Sayfa Aralığı: 74 - 79 Metin Dili: İngilizce DOI: 10.4274/uob.galenos.2019.1335 İndeks Tarihi: 09-10-2020

Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study

Öz:
Objective: The aim of this study is to investigate the surgical and functional outcomes of laparoscopic partial nephrectomy (LPN) in patients with renal angiomyolipoma (RAML).Materials and Methods: From April 2014 to February 2018, the data of a total of 346 patients who underwent LPN were retrospectively reviewed. Twentyone patients with final pathology report indicating RAML were included in the study. Demographic data, operative indications, intraoperative and postoperative outcomes as well as complications were evaluated.Results: Eighteen female (85.7%) and 3 male (14.3%) patients were included in this study. The mean age was 55.14±11.95 years. Of the RAMLs, 52.4% were in the right kidney and 47.6% in the left kidney. The mean tumor size was 31.38±16.72 mm and the mean RENAL Nephrometry score was 5.90±1.51 (4-10). RAML could not be differentiated from RCC in 12 patients (57.1%) by preoperative computer tomography and/or magnetic resonance images. In 4 patients, LPN was implemented by off-clamp technique whereas, in 17 patients it was implemented by global ischemia technique. The mean operation duration was 67.86±20.77 (40-110) minutes (min) and the mean estimated blood loss was 117.14±59.7 (30-220) milliliters. In 17 patients who underwent LPN by global ischemia technique, the mean warm ischemia time was 10.88±5.19 (6-22) min. According to the Modified Clavien-Dindo classification, grade 1 complications were detected in 3 patients, postoperatively. The most considerable renal functional changes were detected between preoperative and postoperative- 1st day levels. However, at the end of the first year, the difference was found to decrease.Conclusion: LPN is a safe and effective treatment option for the treatment of RAMLs that are not able to be distinguished from renal cell carcinoma radiologically. Besides the definitive treatment, the exact pathological diagnosis can be ensured by LPN.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Bhatt JR, Richard PO, Kim NS, et al. Natural History of Renal Angiomyolipoma (AML): Most Patients with Large AMLs >4cm Can Be Offered Active Surveillance as an Initial Management Strategy. European urology 2016;70:85-90.
  • 2. Delhorme JB, Fontana A, Levy A, et al. Renal angiomyolipomas: At least two diseases. A series of patients treated at two European institutions. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 2017;43:831-836.
  • 3. Park BK. Renal Angiomyolipoma: Radiologic Classification and Imaging Features According to the Amount of Fat. AJR American journal of roentgenology 2017;209:826-835.
  • 4. Flum AS, Hamoui N, Said MA, et al. Update on the Diagnosis and Management of Renal Angiomyolipoma. The Journal of urology 2016;195:834-846.
  • 5. Singh D, Rubenstein M, Gill IS. Laparoscopic partial nephrectomy. Journal of endourology 2005; 19:451-455; discussion 455.
  • 6. Gill IS, Rassweiler JJ. Retroperitoneoscopic renal surgery: our approach. Urology 1999;54:734-738.
  • 7. Levey AS, Stevens LA. Estimating GFR using the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation: more accurate GFR estimates, lower CKD prevalence estimates, and better risk predictions. American journal of kidney diseases : the official journal of the National Kidney Foundation 2010;55:622-627.
  • 8. Liu X, Ma X, Liu Q, et al. Retroperitoneal laparoscopic nephron sparing surgery for large renal angiomyolipoma: Our technique and experience. A case series of 41 patients. International journal of surgery 2018;54:216-221.
  • 9. Chronopoulos PN, Kaisidis GN, Vaiopoulos CK, et al. Spontaneous rupture of a giant renal angiomyolipoma-Wunderlich’s syndrome: Report of a case. International journal of surgery case reports 2016; 9:140-143.
  • 10. Lienert AR, Nicol D. Renal angiomyolipoma. BJU international 2012;110 Suppl 4:25-27.
  • 11. Cavicchioli FM, D’Elia C, Cerruto MA, et al. Giant bilateral renal angiomyolipomas: a case report. Urologia internationalis 2014;92:366-368.
  • 12. Ljungberg B, Albiges L, Abu-Ghanem Y, et al. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update. European urology 2019;75:799-810.
  • 13. Sureka B, Khera PS. Radiologic Classification and Imaging Features of Renal Angiomyolipomas According to the Amount of Fat. AJR American journal of roentgenology 2018;210:W136.
  • 14. Mues AC, Palacios JM, Haramis G, et al. Contemporary experience in the management of angiomyolipoma. Journal of endourology 2010;24:1883-1886.
  • 15. Muller A, Rouviere O. Renal artery embolization-indications, technical approaches and outcomes. Nature reviews Nephrology 2015;11:288-301.
  • 16. Husillos Alonso A, Subira Rios D, Bolufer Moragues E, et al. Laparoscopic partial nephrectomy with prior superselective embolisation as treatment for giant renal angiomyolipoma. Actas urologicas espanolas 2018;42:64-68.
  • 17. Kara O, Akca O, Zargar H, et al. Robotic Partial Nephrectomy in the Treatment of Renal Angiomyolipoma. Journal of endourology 2016;30:275-279.
  • 18. Makki A, Graumann O, Hoyer S, et al. Cryoablation of Renal Angiomyolipoma: An Evaluation of Safety and Efficacy. Journal of endourology 2017;31:1117-1122.
  • 19. Castle SM, Gorbatiy V, Ekwenna O, et al. Radiofrequency ablation (RFA) therapy for renal angiomyolipoma (AML): an alternative to angio-embolization and nephron-sparing surgery. BJU international 2012;109:384-387.
  • 20. Sivalingam S, Nakada SY. Contemporary minimally invasive treatment options for renal angiomyolipomas. Current urology reports 2013;14:147-153.
  • 21. Ramon J, Rimon U, Garniek A, et al. Renal angiomyolipoma: longterm results following selective arterial embolization. European urology 2009;55:1155-1161.
  • 22. Villalta JD, Sorensen MD, Durack JC, et al. Selective arterial embolization of angiomyolipomas: a comparison of smaller and larger embolic agents. The Journal of urology 2011;186:921-927.
  • 23. Eijkemans MJ, van der Wal W, Reijnders LJ, et al. Long-term Follow-up Assessing Renal Angiomyolipoma Treatment Patterns, Morbidity, and Mortality: An Observational Study in Tuberous Sclerosis Complex Patients in the Netherlands. American journal of kidney diseases : the official journal of the National Kidney Foundation 2015;66:638-645.
  • 24. Bardin F, Chevallier O, Bertaut A, et al. Selective arterial embolization of symptomatic and asymptomatic renal angiomyolipomas: a retrospective study of safety, outcomes and tumor size reduction. Quantitative imaging in medicine and surgery 2017;7:8-23.
  • 25. Wang C, Yang M, Tong X, et al. Transarterial embolization for renal angiomyolipomas: A single centre experience in 79 patients. The Journal of international medical research 2017;45:706-713.
  • 26. Caputo PA, Zargar H, Ramirez D, et al. Cryoablation versus Partial Nephrectomy for Clinical T1b Renal Tumors: A Matched Group Comparative Analysis. European urology 2017;71:111-117.
  • 27. Boorjian SA, Frank I, Inman B, et al. The role of partial nephrectomy for the management of sporadic renal angiomyolipoma. Urology 2007;70:1064-1068.
  • 28. Minervini A, Giubilei G, Masieri L, et al. Simple enucleation for the treatment of renal angiomyolipoma. BJU international 2007;99:887-891.
  • 29. Qin C, Wang Y, Li P, et al. Super-Selective Artery Embolization before Laparoscopic Partial Nephrectomy in Treating Renal Angiomyolipoma. Urologia internationalis 2017;99:277-282.
  • 30. Simmons MN, Chung BI, Gill IS. Perioperative efficacy of laparoscopic partial nephrectomy for tumors larger than 4 cm. European urology 2009;55:199-207.
  • 31. Msezane L, Chang A, Shikanov S, et al. Laparoscopic nephronsparing surgery in the management of angiomyolipoma: a single center experience. Journal of endourology 2010;24:583-587.
  • 32. Klatte T, Ficarra V, Gratzke C, et al. A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy. European urology 2015;68:980-992.
APA Mercimek M, Ozden E, Ozbek L (2020). Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study. , 74 - 79. 10.4274/uob.galenos.2019.1335
Chicago Mercimek Mehmet Necmettin,Ozden Ender,Ozbek Latif Mustafa Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study. (2020): 74 - 79. 10.4274/uob.galenos.2019.1335
MLA Mercimek Mehmet Necmettin,Ozden Ender,Ozbek Latif Mustafa Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study. , 2020, ss.74 - 79. 10.4274/uob.galenos.2019.1335
AMA Mercimek M,Ozden E,Ozbek L Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study. . 2020; 74 - 79. 10.4274/uob.galenos.2019.1335
Vancouver Mercimek M,Ozden E,Ozbek L Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study. . 2020; 74 - 79. 10.4274/uob.galenos.2019.1335
IEEE Mercimek M,Ozden E,Ozbek L "Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study." , ss.74 - 79, 2020. 10.4274/uob.galenos.2019.1335
ISNAD Mercimek, Mehmet Necmettin vd. "Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study". (2020), 74-79. https://doi.org/10.4274/uob.galenos.2019.1335
APA Mercimek M, Ozden E, Ozbek L (2020). Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study. Üroonkoloji Bülteni, 19(2), 74 - 79. 10.4274/uob.galenos.2019.1335
Chicago Mercimek Mehmet Necmettin,Ozden Ender,Ozbek Latif Mustafa Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study. Üroonkoloji Bülteni 19, no.2 (2020): 74 - 79. 10.4274/uob.galenos.2019.1335
MLA Mercimek Mehmet Necmettin,Ozden Ender,Ozbek Latif Mustafa Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study. Üroonkoloji Bülteni, vol.19, no.2, 2020, ss.74 - 79. 10.4274/uob.galenos.2019.1335
AMA Mercimek M,Ozden E,Ozbek L Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study. Üroonkoloji Bülteni. 2020; 19(2): 74 - 79. 10.4274/uob.galenos.2019.1335
Vancouver Mercimek M,Ozden E,Ozbek L Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study. Üroonkoloji Bülteni. 2020; 19(2): 74 - 79. 10.4274/uob.galenos.2019.1335
IEEE Mercimek M,Ozden E,Ozbek L "Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study." Üroonkoloji Bülteni, 19, ss.74 - 79, 2020. 10.4274/uob.galenos.2019.1335
ISNAD Mercimek, Mehmet Necmettin vd. "Laparoscopic Partial Nephrectomy for Renal Angiomyolipoma: A Retrospective Cohort Study". Üroonkoloji Bülteni 19/2 (2020), 74-79. https://doi.org/10.4274/uob.galenos.2019.1335