Value of preoperative renal artery embolization in reducing blood transfusion requirements during nephrectomy for renal cell carcinoma.
OBJECTIVE
The authors evaluated the effectiveness of preoperative ethanol renal artery embolization in reducing transfusion requirements during nephrectomy for renal cell carcinoma.


METHODS
Of 93 consecutive patients who underwent nephrectomy for renal cell carcinoma from 1980 to 1990, 24 patients underwent embolization within 24 hours of nephrectomy. Finding in this group were compared with those in 69 control patients who underwent surgery without preoperative embolization.


RESULTS
Embolized tumors were larger than nonembolized ones (mean volume, 595 vs 257 mL) (P < .05). Patients with large hypervascular tumors (volume over 250 mL) who underwent complete embolization received significantly smaller mean blood transfusion volumes than control patients (250 vs 800 mL; P = .01). The transfusion volume associated with incomplete embolization was higher than that associated with no embolization.


CONCLUSIONS
Complete alcohol embolization significantly reduces the volume of blood transfused during nephrectomy for large hypervascular renal cell carcinomas, and incomplete embolization is associated with larger transfusions. Preoperative embolization must be complete and should be performed more widely.
Bakal
C W
CW
Department of Radiology, Albert Einstein College of Medicine, Bronx, New York.
Cynamon
J
J
Lakritz
P S
PS
Sprayregen
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011300:Preoperative Care; D012077:Renal Artery