[Laparoscopic partial nephrectomy with superselective balloon embolization of renal artery]

Area of Science:

• Urology
• Interventional Radiology
• Nephrology

Background:

• Partial nephrectomy is a standard treatment for renal malignancy.
• Intraoperative hemostasis can be challenging during these procedures.
• Minimizing damage to healthy renal parenchyma is crucial for preserving kidney function.

Purpose of the Study:

• To evaluate the efficacy of superselective balloon embolization of segmental renal artery branches for intraoperative hemostasis during laparoscopic partial nephrectomy.
• To assess the impact of this technique on renal ischemia and preservation of healthy parenchyma.

Main Methods:

• A prospective study involving 11 patients undergoing laparoscopic partial nephrectomy for renal tumors.
• Superselective balloon embolization of segmental renal artery branches was performed prior to tumor resection.
• Preoperative evaluation included ultrasound, MSCT, renal scintigraphy, and R.E.N.A.L. nephrometry scoring.

Main Results:

• Mean blood loss was 50 mL.
• The mean duration of the laparoscopic stage was 104.3 minutes.
• Superselective embolization minimized ischemic injury to surrounding parenchyma, ensuring dry resection margins.
• Postoperative renal ultrasounds showed no significant pathological findings.

Conclusions:

• Superselective balloon embolization is an effective method for achieving intraoperative hemostasis during partial nephrectomy.
• This technique helps maintain blood circulation in intact parenchyma, preventing acute kidney injury.
• Balloon occlusion offers an advantage over permanent embolization agents by minimizing ischemic damage to healthy tissue.