Primary robot-assisted laparoscopic partial nephrectomy for hemorrhage secondary to angiomyolipoma: a retrospective study from a large tertiary hospital in China

Xintao Hua ^1,2, Zeqi Chen ^2,3, Xinyu Zhang ^2,3

⁰The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.

Scientific Reports +

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September 28, 2024

View abstract on PubMed

Summary

Robot-assisted Laparoscopic Partial Nephrectomy (RALPN) is a safe and effective primary treatment for Hemorrhage secondary to angiomyolipoma (HSA). This minimally invasive approach offers a viable alternative to traditional methods, with manageable complications and successful hemorrhage control.

Area Of Science

Urology
Minimally Invasive Surgery
Oncology

Background

Angiomyolipoma (AML) can cause significant Hemorrhage (HSA), posing a clinical challenge.
Robot-assisted Laparoscopic Partial Nephrectomy (RALPN) is emerging as a treatment option for renal masses.
Primary RALPN for HSA is infrequently reported, necessitating further investigation.

Purpose Of The Study

To evaluate the efficacy and safety of primary Robot-assisted Laparoscopic Partial Nephrectomy (RALPN) for treating Hemorrhage secondary to angiomyolipoma (HSA).

Main Methods

Retrospective analysis of fourteen patients who underwent primary RALPN for HSA between 2015 and 2023.
Preoperative assessment included blood routine and Contrast-enhanced computed tomography (CT) for retroperitoneal hematoma.
Surgical technique involved transabdominal access, tumor resection, hematoma removal, and closure with absorbable barbed sutures.

Main Results

All fourteen patients (aged 14-56) achieved successful hemorrhage control with primary RALPN.
Tumor sizes ranged from 57-145 mm, with RENAL scores between 7-11.
Postoperative complications were limited to chylous drainage (Clavien-Dindo II) and pleural effusion (Clavien-Dindo III) in one patient each; no transfusions or embolization were required.

Conclusions

Primary RALPN is a safe and effective surgical option for managing Hemorrhage secondary to angiomyolipoma (HSA).
This minimally invasive technique provides successful hemorrhage control and avoids the need for postoperative transfusions or embolization.
RALPN can be considered a valuable alternative to selective renal artery embolization for HSA.

Keywords:

Angiomyolipoma Hemorrhage Laparoscopy Robot-assisted surgery