To assess the safety, tumor control and renal function preservation of the emergency retroperitoneal laparoscopic partial nephrectomy (LPN) for ruptured renal angiomyolipoma (AML) and summarize our single-center initial experience. We performed a retrospective analysis of 15 patients pathologically confirmed renal AML treated with emergency retroperitoneal LPN between January 2016 and May 2019. The patient demographics, operation time, blood loss, transfusion requirements, complications and other surgical parameters were analyzed. Follow-up was performed by serum creatinine and imaging modalities. Fifteen patients were performed with emergency LPN with the median age 41.6 years. The mean size of the renal AMLs was 7.8 cm. The mean size of the retroperitoneal hematomas was 8.5 cm. All the emergency surgeries were performed successfully without any conversion to nephrectomy or open surgery. The mean operative time was 101 min. The mean warm ischemia time was 28 min. The mean estimated blood loss was 311 ml. Five patients required intraoperative blood transfusion (33.3%, 5/15). The mean transfused RBC was 4 U (range 2-6 U), and the mean transfused plasma was 200 ml (range 200-400 ml). The mean drainage duration was 3 days (range 2–5 days). The mean postoperative hospitalization was 4.7 days. No patients experienced intraoperative complications. The mean serum creatine was slightly higher after surgery (53.1 vs. 55.9 μmol/L). One patient had postoperative perirenal fluid collection. No patients needed dialysis. No recurrence was observed in the patients at the median follow-up of 24.1 months. Our initial experience shows that the emergency retroperitoneal LPN is a safe, minimally invasive procedure for emergency patients with ruptured renal AMLs. It could be considered as an effective alternative to renal artery embolization in selected emergency patients.

中文翻译：

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紧急腹膜后腹腔镜部分肾切除术治疗破裂性肾血管肌脂瘤：回顾性单中心研究15例。

为了评估紧急腹膜后腹腔镜部分肾切除术（LPN）用于破裂性肾血管平滑肌脂肪瘤（AML）的安全性，肿瘤控制和肾功能保护，并总结我们的单中心初步经验。我们对2016年1月至2019年5月间经急诊腹膜后LPN治疗的15例经病理证实的肾AML进行了回顾性分析。分析了患者的人口统计学，手术时间，失血量，输血需求，并发症和其他手术参数。通过血清肌酐和成像方式进行随访。15例患者接受了紧急LPN治疗，中位年龄为41.6岁。肾脏AML的平均大小为7.8 cm。腹膜后血肿的平均大小为8.5厘米。所有急诊手术均成功完成，无需进行任何肾切除术或开放手术。平均手术时间为101分钟。平均温暖缺血时间为28分钟。平均估计失血量为311毫升。五例患者需要术中输血（33.3％，5/15）。平均输血RBC为4 U（范围2-6 U），平均输血血浆为200 ml（范围200-400 ml）。平均引流时间为3天（范围2-5天）。术后平均住院时间为4.7天。没有患者经历术中并发症。术后平均血清肌酸水平略高（53.1 vs. 55.9μmol/ L）。一名患者术后收集肾周液。没有患者需要透析。在中位随访24.1个月时未观察到复发。我们的初步经验表明，对于肾AML破裂的紧急患者，紧急腹膜后LPN是一种安全，微创的手术。在某些急诊患者中，它可以被认为是肾动脉栓塞的有效替代方法。