Transarterial embolization of renal tumors improves surgical outcomes: A case series

INTRODUCTION: Operative treatment of renal tumors can be associated with a high rate of perioperative morbidity related to hemorrhage and injury to adjacent anatomical structures. This morbidity of solid organ surgery is especially prevalent when the lesion involves chronic inflammation or a desmoplastic reaction from a rapidly growing tumor. No consensus on the use of transarterial embolization has been fashioned as the number of prospective studies is small. This study proposes to examine the beneficial effects of selective transarterial embolization of the kidney prior to surgical resection. PRESENTATION OF CASE: A retrospective case matched review was performed of consecutive nephroureterectomies evaluating outcomes of patients receiving transarterial embolization versus those patients who received no embolization. The records were obtained from University Medical Center of El Paso for the time period of 05/2011–12/2014. Data examined included patient demographics, operative blood loss, operative time, transfusion requirements, and pathology. Previous studies have shown that preoperative embolization of renal tumors resulted in a decreased need for blood transfusion. CONCLUSION: Our review showed transarterial embolization had a decrease in blood loss and required no transfusions. It also facilitated a larger and more advanced tumor resection. Our series of patients tolerated transarterial embolization well and had good surgical outcomes. Transarterial embolization of kidneys prior to radical nephroureterectomy results in a safe and uncomplicated operative course with less perioperative morbidity when compared to resection alone.