Selective arterial embolization in the treatment of hemorrhage after robot-assisted partial nephrectomy:a propensity score matching study
Chen Dong
Gu Liangyou
Huang Qingbo
Jia Tongyu
Jia Yuqi
Li Hongzhao
Ma Xin
Zhang Xu
Abstract：Objective:To analyze and summarize clinical characteristic and prognosis of postoperative hemor-rhage patients with treatment of selective arterial embolization undergoing robot-assisted partial nephrectomy.Meth-od:13 patients with postoperative hemorrhage treated by embolization surgery after robot-assisted partial nephrecto-my in the the First Medical Center of PLA General Hospital from 2013 to 2021 were retrospectively analyzed,260 patients were randomly chosen as control group from individuals without embolization.Comparison in clinically tumor-ous characteristic and operative data was performed between two groups.The method of propensity score matching was used to compare renal function and oncology outcomes of patients in the two groups by 1:4 matching considering clinical and tumor characteristics.Results:13 embolized patients compared with 260 unembolized patients,In the em-bolization group,the median R.E.N.A.L score of the tumor was higher(8 vs.6,P=0.006),the proportion of com-plete endogenesis was higher(46.2%vs.9.6%,P=0.002),and the proportion of immediate collection system was higher(84.6%vs.34.6%,P=0.002).The median time from partial resection to embolization was 7 days(IQR:1,10).The most common symptom was gross hematuria(9/13,69.2%),followed by low back pain(3/13,23.1%).Two patients underwent secondary renal artery embolization due to recurrence of hematuria.After pairing,there were no differences in preoperative clinical and tumor characteristics and surgical outcomes between the two groups.There was no significant difference in follow-up eGFR between the two groups.Conclusion:Selective arterial embolization is an effective method to control bleeding after robot-assisted partial nephrectomy while preserving renal function.High R.E.N.A.L score,complete endogeneity,and adjacent collection system are the tumor characteristics of pa-tients with selective arterial embolization after robot-assisted partial nephrectomy,warranting close monitoring.
Keywords：robotic surgical procedurespostoperative hemorrhageembolism
Publication Date：2024-02-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 24-30 )