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Abstract：
To analyze and compare the intraoperative and post-operative outcomes of \"on-clamp\" laparoscopic partial nephrectomy (LPN) with \"preoperative super-selective angioembolization\" before LPN. This randomized clinical study was conducted at Gauhati Medical College Hospital, Guwahati, India, between November 2021 and November 2023. Adult patients of either gender diagnosed with T1 renal tumors were included in the study. All patients underwent diethylenetriamine pentaacetate scan preoperatively and at 1-month follow-up. The patients were randomized using a parallel group design with an allocation ratio of 1:1 to receive either preoperative angioembolization followed by LPN or conventional \"on-clamp\" LPN. Demographic and baseline parameters were recorded along with pre- and post-operative data. There was no significant difference between the two groups in terms of age (P = 0.11), gender distribution (P = 0.32), body mass index (P = 0.43), preoperative hemoglobin (P = 0.34), and preoperative estimated glomerular filtration rate (eGFR; P = 0.64). One patient in the embolization group required radical nephrectomy because of accidental backflow of glue into the renal artery during embolization whereas four patients required clamping due to inadequate embolization. Preoperative super-selective embolization yielded significantly less blood loss, compared to \"on-clamp\" LPN (145 [50.76 mL] vs. 261 [66.12 mL], P < 0.01). There was no significant difference between post-operative eGFR (at 1 month) between the two groups (P = 0.71). Preoperative embolization offers improved outcomes in the dissection plane, total operative time, and blood loss, compared to conventional \"on-clamp\" LPN but has no significant effect on change in eGFR.
摘要：
分析并比较腹腔镜肾部分切除术（LPN）与LPN前“术前超选择性血管栓塞”的术中和术后疗效。这项随机临床研究是在高哈蒂医学院附属医院进行的，Guwahati,印度,2021年11月至2023年11月之间。该研究包括诊断为T1肾肿瘤的任何性别的成年患者。所有患者术前和随访1个月时均接受二乙烯三胺五乙酸盐扫描。患者采用平行组设计，分配比例为1：1，接受术前血管栓塞，然后接受LPN或常规“钳夹”LPN。记录人口统计学和基线参数以及术前和术后数据。两组患者年龄差异无统计学意义(P=0.11),性别分布(P=0.32)，体重指数（P=0.43），术前血红蛋白（P=0.34），术前估计肾小球滤过率(eGFR;P=0.64)。栓塞组中的一名患者由于栓塞期间胶水意外回流到肾动脉而需要根治性肾切除术，而四名患者由于栓塞不足而需要夹紧。术前超选择性栓塞术的失血量明显减少，与“on-clamp”LPN（145[50.76mL]vs.261[66.12毫升],P<0.01)。两组术后1个月eGFR比较差异无统计学意义(P=0.71)。术前栓塞可改善夹层平面的结果，总手术时间,失血,与传统的“on-clamp”LPN相比，但对eGFR的变化没有显著影响。
