Nephron-sparing surgery with preoperative selective arterial embolization in management of giant renal angiomyolipomas

This study aimed to evaluate the effect of nephron-sparing surgery (NSS) along with preoperative selective arterial embolization (SAE) on the treatment of giant renal angiomyolipomas (AML). Between July 2010 and October 2014, 3 men and 8 women with 11 sporadic giant renal AMLs were treated by NSS along with preoperative SAE in our center. The tumor size ranged from 10.4 to 24.2 cm. The medical data were collected. Of the 11 giant AMLs, 8 were completely devascularized by SAE, and the other 3 were mostly devascularized. The rate of post-embolization syndrome was 27.2% (3/11). NSS was successfully performed after SAE in all patients. The operating time was 70155 min (mean, 115 min). Blood loss was 50-150 ml (mean, 70 ml). The warm ischemia time was 8-25 min (mean, 15 min). The incidence of perioperative complications was 18.2% (2/11), and no severe complications occurred after NSS. The hospitalization time after NSS was 5-10 d (mean, 6.6 d). There was no statistical difference in kidney function preand post-surgery. No evidence of recurrence was found during the follow-up period. NSS with preoperative SAE can be considered a viable and effective treatment option for giant renal AMLs, for it avoids excess blood loss and shortens warm ischemia time during NSS.