Angiomyolipoma surgery: Difference between revisions
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=== Radiofrequency Ablation or Cyroablation: === | === Radiofrequency Ablation or Cyroablation: === | ||
It is considered to be safe and effective alternative to embloization and nephron sparing surgery, used in the treatment of renal masses <3 cm or smaller without bleeding complications.<ref name="pmid23345372">{{cite journal| author=Atwell TD, Schmit GD, Boorjian SA, Mandrekar J, Kurup AN, Weisbrod AJ et al.| title=Percutaneous ablation of renal masses measuring 3.0 cm and smaller: comparative local control and complications after radiofrequency ablation and cryoablation. | journal=AJR Am J Roentgenol | year= 2013 | volume= 200 | issue= 2 | pages= 461-6 | pmid=23345372 | doi=10.2214/AJR.12.8618 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23345372 }}</ref> | It is considered to be safe and effective alternative to embloization and nephron sparing surgery, used in the treatment of renal masses <3 cm or smaller without bleeding complications.<ref name="pmid23345372">{{cite journal| author=Atwell TD, Schmit GD, Boorjian SA, Mandrekar J, Kurup AN, Weisbrod AJ et al.| title=Percutaneous ablation of renal masses measuring 3.0 cm and smaller: comparative local control and complications after radiofrequency ablation and cryoablation. | journal=AJR Am J Roentgenol | year= 2013 | volume= 200 | issue= 2 | pages= 461-6 | pmid=23345372 | doi=10.2214/AJR.12.8618 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23345372 }}</ref><ref name="pmid19493268">{{cite journal| author=Sooriakumaran P, Gibbs P, Coughlin G, Attard V, Elmslie F, Kingswood C et al.| title=Angiomyolipomata: challenges, solutions, and future prospects based on over 100 cases treated. | journal=BJU Int | year= 2010 | volume= 105 | issue= 1 | pages= 101-6 | pmid=19493268 | doi=10.1111/j.1464-410X.2009.08649.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19493268 }}</ref> | ||
==References== | ==References== | ||
Revision as of 09:02, 1 August 2018
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Angiomyolipoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Angiomyolipoma surgery On the Web |
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American Roentgen Ray Society Images of Angiomyolipoma surgery |
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Risk calculators and risk factors for Angiomyolipoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [3]
Overview
Surgery is not the first-line treatment option for patients with angiomyolipoma. Transcatheter arterial embolization is usually reserved for patients with complicated disease.[1]
Surgery
Angiomyolipoma do not normally require surgery unless there is life-threatening bleeding.
Transcatheter Arterial Embolization
- Proximal Embolization
- These are appropriate for the occlusion of a large lumen without distal migration
- Distal Embolization
- These are appropriate for the occlusion of a large lumen with distal migration
- Palliative Embolization
- Embolization in patients with end-stage renal disease
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A -
B -
C -
D
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- Figures A-D: Angiographic runs showed a significantly ptosed right kidney, with supply to the large upper pole angiomyolipoma via tortuous artery arising from the superior division of the right renal artery.[2]
Embolization Procedure
- Selective catheterization of the branch supplying the angiomyolipoma is achieved via microcatheter
- Contrast is infused
- Embolization is usually performed using a 50:50 dilution of absolute alcohol in lipiodol
- A total of 12 mL is injected under careful angiographic observation to ensure no reflux to vessels supplying renal cortex
Partial Nephrectomy
Larger, symptomatic and ruptured angiomyolipomas, can be electively resected with a partial nephrectomy.[3] [4] with the advantage of a kidney preservation and the benefits of a minimal invasive procedure without compromising the safety of the patient.
Complete Nephrectomy:
Complete nephrectomy is usually considered in cases where risk of development of the urinary fistula and of hemorrhage is high after partial nephrectomy.
Radiofrequency Ablation or Cyroablation:
It is considered to be safe and effective alternative to embloization and nephron sparing surgery, used in the treatment of renal masses <3 cm or smaller without bleeding complications.[5][6]
References
- ↑ Lewis JH, Weingold AB (1985). "The use of gastrointestinal drugs during pregnancy and lactation". Am J Gastroenterol. 80 (11): 912–23. PMID 2864852.
- ↑ Image courtesy of Dr. Andrew Lawson. Radiopaedia(original file [1]). Creative Commons BY-SA-NC
- ↑ Treatment and Prognosis. http://radiopaedia.org/articles/renal-angiomyolipoma
- ↑ Ploumidis A, Katafigiotis I, Thanou M, Bodozoglou N, Athanasiou L, Ploumidis A (2013). "Spontaneous Retroperitoneal Hemorrhage (Wunderlich Syndrome) due to Large Upper Pole Renal Angiomyolipoma: Does Robotic-Assisted Laparoscopic Partial Nephrectomy Have a Role in Primary Treatment?". Case Rep Urol. 2013: 498694. doi:10.1155/2013/498694. PMC 3784227. PMID 24106637.
- ↑ Atwell TD, Schmit GD, Boorjian SA, Mandrekar J, Kurup AN, Weisbrod AJ; et al. (2013). "Percutaneous ablation of renal masses measuring 3.0 cm and smaller: comparative local control and complications after radiofrequency ablation and cryoablation". AJR Am J Roentgenol. 200 (2): 461–6. doi:10.2214/AJR.12.8618. PMID 23345372.
- ↑ Sooriakumaran P, Gibbs P, Coughlin G, Attard V, Elmslie F, Kingswood C; et al. (2010). "Angiomyolipomata: challenges, solutions, and future prospects based on over 100 cases treated". BJU Int. 105 (1): 101–6. doi:10.1111/j.1464-410X.2009.08649.x. PMID 19493268.