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The Role of Partial Nephrectomy without Arterial Embolization in Giant Renal Angiomyolipoma

机译:不行动脉栓塞的部分肾切除术在巨大肾血管平滑肌脂肪瘤中的作用

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摘要

Angiomyolipoma is a benign neoplasm composed of varying admixtures of blood vessels, smooth muscle cells, and adipose tissue. Because of an increased risk of spontaneous haemorrhage, surgical approach is needed greater than 4–8 cm size. We here report our partial nephrectomy experience in the 24 cm size giant angiomyolipoma. 26-year-old woman referred to our clinic with a 24 cm size angiomyolipoma in her lower pole of right kidney. The inferior vena cava was deviated to the left by the mass. All the blood tests were normal and we offered her the choices of partial nephrectomy or nephrectomy. Right subcostal approach was used. The patient underwent resection of the mass with a safety region of 1 cm. Frozen section evaluation was consistent with angiomyolipoma and free for surgical margin. Warm ischemia time was 35 min. and intraoperative bleeding volume was 200 cc. Postoperative 2nd day the drain was taken and hospital stay was 4 days. In literature we observed very rare angiomyolipoma cases with such a large dimension treated by partial nephrectomy without arterial embolization. If technically suitable partial nephrectomy is the main chioce in this kind of benign lesions in young patients.
机译:血管平滑肌脂肪瘤是一种良性肿瘤,由血管,平滑肌细胞和脂肪组织的各种混合物组成。由于自发性出血的风险增加,因此需要采用大于4-8cm的手术方法。我们在此报告在24 cm大小的巨血管平滑肌脂肪瘤中进行部分肾切除术的经验。一位26岁的妇女因右肾下极转移到我们的诊所,其血管平滑肌脂肪瘤的大小为24厘米。下腔静脉被肿块向左偏斜。所有血液检查均正常,我们为她提供了部分肾切除术或肾切除术的选择。采用右肋下入路。病人行肿块切除,安全区域为1 cm。冷冻切片评估与血管平滑肌脂肪瘤一致,且手术边缘免费。温暖的缺血时间为35分钟。术中出血量为200 cc。术后第二天引流,住院4天。在文献中,我们观察到极少见的血管平滑肌脂肪瘤病例,通过不进行动脉栓塞的部分肾切除术进行了如此大的手术。如果技术上合适的话,部分肾切除术是年轻患者这种良性病变的主要选择。

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