En Bloc Ligation of Renal Hilum Considered Safe
En bloc ligation is more safe and beneficial in terms of perioperative factors than conventional renal pedicle dissection and isolated vascular ligation.
HealthDay News — En bloc renal hilar vascular staple ligation is as safe as conventional renal pedicle dissection and isolated staple ligation of the renal artery and vein, according to a review published in the January issue of The Journal of Urology.
Win Shun Lai, MD, and Soroush Rais-Bahrami, MD, from the University of Alabama at Birmingham, conducted a literature review to examine the safety of en bloc ligation of the renal hilum. 9 studies were identified for review; 4 of these included a control group and were used for meta-analysis.
The researchers found that at an average postoperative follow-up of 26.5 months, none of the 595 patients in whom en bloc ligation was performed for nephrectomy were diagnosed with arteriovenous fistula formation. Meta-analysis showed a significant improvement in procedure duration for en bloc nephrectomy when comparing en bloc and isolated ligation of the renal artery and vein. The estimated blood loss and number of complications did not differ.
"En bloc ligation appears to be as safe as and potentially more beneficial in terms of perioperative factors than conventional renal pedicle dissection and isolated vascular ligation," the authors write.
- Lai WS, Rais-Bahrami S. Safety and Efficacy of En Bloc Renal Hilar Vascular Staple Ligation: A Meta-Analysis. J Urol. 2017 Jan;197(1):175-181. doi: 10.1016/j.juro.2016.07.077.