title: Laparoscopic nephron-sparing surgery in the management of angiomyolipoma: a single center experience.
abstract: OBJECTIVE
  Angioembolization is often the first-line treatment for patients with renal angiomyolipoma (AML). Regrowth and repeated hemorrhage after embolization, however, remain a concern. Laparoscopic partial nephrectomy (LPN) is the definitive, minimally invasive treatment alternative. We compared the outcomes of LPN in patients who had a diagnosis of AML with patients with other renal tumors.
  
  
  METHODS
  From a prospective LPN database, we identified patients with a final pathologic diagnosis of AML (group 1). The ability of preoperative imaging to predict AML final pathology results was studied. Surgical and postoperative outcomes in group 1 were compared with the outcomes of the rest of our LPN cohort (group 2).
  
  
  RESULTS
  Of 184 LPNs that were performed between 2002 and 2008, 14 (7.6%) patients and 15 renal units had a diagnosis of AML. Two patients underwent concomitant LPN and radiofrequency ablation (RFA) for multiple AML lesions. In group 1, only 33% of the patients had a preoperative diagnosis of AML. There were no significant differences in tumor size, age, preoperative estimated creatinine clearance, body mass index, and comorbidities between the groups. The mean estimated blood loss in groups 1 and 2 was 214 mL and 178 mL, respectively (P = 0.5). The complication rates were similar between the groups. With a median follow-up of 15 months, no AML recurrences or bleeding was observed in group 1.
  
  
  CONCLUSIONS
  The results of LPN or RFA, when appropriate, in AML patients are comparable to the results of LPN for other renal tumors. The preoperative imaging studies were a poor predictor of AML in patients who were undergoing LPN.
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois, USA.
authors.forename: Lambda
authors.initials: L
authors.lastname: Msezane
authors.forename: Anthony
authors.initials: A
authors.lastname: Chang
authors.forename: Sergey
authors.initials: S
authors.lastname: Shikanov
authors.forename: Tom
authors.initials: T
authors.lastname: Deklaj
authors.forename: Mark H
authors.initials: MH
authors.lastname: Katz
authors.forename: Arieh L
authors.initials: AL
authors.lastname: Shalhav
authors.forename: David A
authors.initials: DA
authors.lastname: Lifshitz
mesh_terms: D018207:Angiomyolipoma / Q000601:surgery*; D003710:Demography; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009399:Nephrons / Q000473:pathology / Q000601:surgery*; D019990:Perioperative Care