Nephron-sparing surgery for renal angiomyolipoma in middle aged and elderly patients / 中华老年医学杂志

ABSTRACT

Objective To evaluate the effcacy and safety of nephron-sparing surgery(NSS) in the treatment of renal angiomyolipoma(AML) in middle-aged and elderly patients.Methods From September 2002 to September 2011,NSS was performed in 12 cases with renal AML in our hospital.Renal function was observed before and after surgery.Tumor size,pathological findings,surgical complications and prognosis were retrospectively analyzed.Clinical features were summarized.Results The age of patients ranged from 45 to 65 years(median 60.2 years).There were 2 males and 10 females in this study,including 1 eases with solitary kidney.Open NSS were performed in 2 cases and laparoscopic surgery in 10 cases.Tumor diameter was(6.8 ±3.3) cm on average,ranged from 3.5 cm to 12.0 cm.Intraoperative findings showed that diameters of AML in the basal kidney were small,similar to themushroom in shape,and the depth of tumor invasion into the renal parenchyma was superficial.Pathologic results showed that pathologically classic AML was found in 9 cases,epithelial-like type in 2 cases,leiomyoma type in 1 case.Mean intraoperative blood loss was 250 ml(100-750 ml).Postoperative retroperitoneal hematoma occurred in 1 case.Serum creatinine level showed no statistically significant difference between pre-surgery and 10 days after surgery [(87 ±34) mmol/L vs.(92±37) mmol/L,t=2.073,P＞0.05].During mean follow-up of 26.5 months (12-48 months),no renal insufficiency was found.Conclusions NSS is an effective and safe treatment for renal AML in middle-aged and elderly patients.