Related Experiment Videos
Renal artery pseudoaneurysm following laparoscopic partial nephrectomy.
Dinesh Singh1, Inderbir S Gill
1Section of Laparoscopic and Robotic Surgery, Glickman Urological Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
The Journal of Urology
|November 11, 2005
Summary
Renal artery pseudoaneurysm is a rare complication after laparoscopic partial nephrectomy. This condition often presents late, with percutaneous embolization being the preferred initial treatment for hemorrhage control.
Area of Science:
- Urology
- Vascular Surgery
- Interventional Radiology
Background:
- Laparoscopic partial nephrectomy (LPN) is a standard procedure for renal tumors.
- Postoperative hemorrhage can occur, with renal artery pseudoaneurysm being a rare but serious complication.
Purpose of the Study:
- To describe the presentation, evaluation, and management of hemorrhage caused by renal artery pseudoaneurysm after LPN.
- To highlight the effectiveness of percutaneous embolization in managing this complication.
Main Methods:
- A retrospective review of 345 LPN cases over 5 years identified 6 patients (1.7%) with postoperative hemorrhage from renal artery pseudoaneurysm.
- Patient charts were analyzed for preoperative, intraoperative, and postoperative data.
Main Results:
- Hemorrhage presented at a median of 12 days postoperatively.
- Renal artery pseudoaneurysms were typically located at third or fourth-order branches.
- Percutaneous embolization was successful in all 6 patients, with no need for blood transfusions or further intervention.
Conclusions:
- Renal artery pseudoaneurysm is an uncommon but significant complication of LPN.
- Delayed presentation is common.
- Selective angiographic embolization is the treatment of choice.