中晚期肾癌术前应用肾动脉栓塞治疗的临床意义

Embolization of Renal Artery before Radical Nephrectomy in Patients with Intermediate-and Advanced-stage of Renal Cell Carcinoma

目的评价中晚期肾癌术前应用肾动脉栓塞治疗的临床意义。方法 24例中晚期肾癌患者(治疗组)行选择性肾动脉造影,注入化疗药物后随即用碘化油、明胶海绵行肾动脉栓塞;3～10 d内行根治性肾切除术。同时选择28例单纯行肾癌根治术的中晚期肾癌患者作为对照组。比较2组术中肿瘤及周围组织改变、手术出血量及手术时间,术后1、3年生存率。结果 2组均顺利完成根治性切除手术。治疗组和对照组术中出血量[(480±160)mL vs(650±233)mL]、手术时间[(2.60±0.42)h vs(3.40±0.50)h]、1年生存率(87.5%vs 78.6%)、3年生存率(64.7%vs 57.1%)比较,差异有统计学意义(均P<0.05)。结论中晚期肾癌术前应用肾动脉栓塞治疗有利于手术切除,对于提高患者生存率具有积极的临床意义。

Objective To evaluate the significance of the embolization of renal artery before radical nephrectomy in patients with intermediate-and advanced-stage of renal cell carcinoma.Methods Fifty-two patients with intermediate-and advanced-stage of renal cell carcinoma were divided into two groups.Patients in treatment group（n=24） underwent radical nephrectomy 3～10 days after preoperative chemoembolization with lipiodol and gel foam.Patients in control group（n=28） received only a radical nephrectomy.Intraoperative changes in the tumor and surrounding tissue,blood loss,operating time,and postoperative survival rate were compared between the two groups.Results All patients successfully underwent radical nephrectomy.There were significant differences in blood loss,operating time,1-year survival rate and 3-year survival rate between treatment group and control group [（480±160） mL vs（650±233） mL,（2.60±0.42） hours vs（3.40±0.50） hours,87.5% vs 78.6%,and 64.7% vs 57.1%,respectively]（all P0.05）.Conclusion Preoperative embolization of renal artery is beneficial to radical nephrectomy and can increase postoperative survival rate in patients with intermediate-and advanced-stage of renal cell carcinoma.