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Vol. 42. Issue 1.
Pages 64-68 (January - February 2018)
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Vol. 42. Issue 1.
Pages 64-68 (January - February 2018)
New Techniques and Technologies
Laparoscopic partial nephrectomy with prior superselective embolization as treatment for giant renal angiomyolipoma
Nefrectomía parcial laparoscópica previa embolización supraselectiva como tratamiento de angiomiolipomas renales gigantes
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A. Husillos Alonsoa,
Corresponding author
adrian.husillos@quironsalud.es

Corresponding author.
, D. Subirá Ríosb, E. Bolufer Moraguesa, I. Lopez Díezb, I. Moncada Iribarrenb, C. González Enguitaa
a Servicio de Urología, Hospital Universitario Infanta Elena/Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
b Servicio de Urología, Hospital Universitario de La Zarzuela, Madrid, Spain
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Table 1. Surgical and postoperative parameters.
Abstract
Objective

Cases of giant renal angiomyolipoma (>9cm) are a therapeutic challenge due to their low frequency and large size. The treatment objective for patients with renal angiomyolipoma should be complete tumor extirpation, with a nephron-sparing surgical technique, without complications and using a minimally invasive approach.

Material and methods

We present 3 cases of giant angiomyolipoma (10, 12 and 14cm) treated with a combined approach: superselective embolization and subsequent laparoscopic partial nephrectomy, in 3 separate hospitals.

Results

None of the cases required conversion to open surgery. One of the 3 patients underwent arterial clamping, and none of the patients had complications.

Conclusions

The combined approach provides a procedure with the criteria of minimal invasiveness, nephron sparing, little bleeding and reduced warm ischemia time.

Keywords:
Laparoscopic partial nephrectomy
Renal tumor
Angiomyolipoma
Embolization
Nephron-sparing surgery
Resumen
Objetivo

Los casos de angiomiolipoma renal gigante (>9cm) son un reto terapéutico por su baja frecuencia y su tamaño. El objetivo del tratamiento de los pacientes con angiomiolipoma renal debe ser la extirpación completa del tumor, con una técnica quirúrgica conservadora de nefronas, sin complicaciones y mediante un abordaje mínimamente invasivo.

Material y métodos

Presentamos 3 casos de angiomiolipoma gigante (14, 12 y 10cm) tratados mediante abordaje combinado: embolización supraselectiva y posterior nefrectomía parcial laparoscópica, en 3 hospitales diferentes.

Resultados

Ningún caso precisó reconversión a cirugía abierta, en uno de los 3 pacientes se realizó clampaje arterial y ninguno experimentó complicaciones.

Conclusiones

El abordaje combinado permite una cirugía con criterios de mínima invasión, conservadora de nefronas, con escaso sangrado y disminución del tiempo de isquemia caliente.

Palabras clave:
Nefrectomía parcial laparoscópica
Tumor renal
Angiomiolipoma
Embolización
Cirugía conservadora de nefronas

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