部分腎臟切除前，利用染劑及明膠海綿行高選擇性血管栓塞之初步報告
廖博崎, 楊晨洸
台中榮民總醫院外科部泌尿科, 台灣
Highly selective arterial embolization with dye and Gelfoam before partial nephrectomy, preliminary report
Po-Chi Liao1, Yang Cheng Kuang
Divisions of Urology1, Department of Surgery, Taichung Veterans General Hospital , Taiwan
Purpose: To introduce our experience of newly developed technique for identify of tumor margin in partial nephrectomy. In our study, we used Gelfoam mix with methyl blue dye for pre-operative TAE material.
Materials and Methods: From October 2016 to October 2017, there were 43 patients accepted partial nephrectomy with single surgeon. Before partial nephrectomy, there were 21 patients accepted highly selective (TAE) with Gelfoam, 4 patients accepted highly selective TAE with Gelfoam and dye, and 18 patients without TAE. Highly selective TAE was performed by Radiologist. During partial nephrectomy, we clumped renal vein and artery followed hypothermia localized at kidney. After excision of renal mass, parenchymal defect was closed via 2-O and 3-O V-Loc suture. Creatinine level was checked after operation.
Results: During the operation, we can easily identify the deep surgical margin in the patients who accepted TAE with Gelfoam and dye. It helps us to excise the tumor close to the margin during operation without injury deep vessel or collecting system, and we can preserve more nephron during operation.
Conclusions: For patients require more precise nephron sparing or tumor with more endophytic feature, this procedure helps us to identified tumor margin without injury to vessel or collection system, which provide benefit in both oncological control and nephron sparing.