肾癌骨转移术前栓塞治疗效果分析

Analysis of the Effect of Preoperative Embolization for Renal Carcinoma with Bone Metastases

目的对术前栓塞后术中手术出血量、手术时间和患者生存率等进行分析,探讨术前栓塞对肾癌骨转移的手术治疗效果。方法回顾性研究132例转移性肾癌患者临床资料,其中41例术前进行栓塞治疗。主要分析结果是术中出血量、手术时间和患者生存率。同时得出了影响手术时间和生存的相关因素。结果非脊椎骨转移术前栓塞治疗对手术中的血量损失的影响差异无统计学意义。转移肿瘤盆腔位置和肿瘤大小与术中出血量密切相关,且肿瘤大小是术中失血的一个独立因素。在肾癌非脊椎骨转移的治疗中,特别是在一个孤立性病变的情况下,边缘切除术治疗是金标准,能提高整体存活率;同时边缘切除术和病灶内切除术、肾切除切除相比,血红蛋白水平和孤立性转移对生存率有较大影响。结论肾癌骨转移病灶位于盆腔且孤立存在时,术前栓塞有益于患者,可减少术中出血量;边缘切除术可以提高患者的整体生存率。

Objective To analyze the operative hemorrhagic volume,operative time and survival rate of patients with preoperative embolization, and to discuss the surgical treatment effect of preoperative embolization on bone metastasis of renal cancer. Methods The clinical data of 132 patients with metastatic renal carcinoma were retrospectively studied,of which 41 were treated with embolization before operation. The primary analysis results were intraoperative blood volume,procedural time, and patient survival rate. At the same time, the related factors affecting the operation time and survival were obtained. Results There was no significant difference in the effect of preoperative embolization of non spinal metastasis on the loss of blood volume in the operation. The location of metastatic tumour in pelvic cavity and the size of tumor were closely related to she amount of intraoperative bleed- ing,and she size of tumor Was an independent factor of intraoperative blood loss. In the treatment of non spinal metastasis of renal cancer, especially in the case of an isolated lesion, marginal resection is the gold standard and can improve the overall survival rate; At the same time, there was a significant impact on the survival rate of patients with peripheral resection and intra-lesion resection and renal resection. Conclusion When bone metastases of renal cell carcinoma are located in the pelvic cavity and isolated, preoperative embolization is beneficial to the patients and can reduce the amount of intraoperative bleeding; Marginal resection can improve the overall survival rate of the patients.