Absence of asymptomatic unruptured renal artery pseudoaneurysm on contrast-enhanced computed tomography after robot-assisted partial nephrectomy without parenchymal renorrhaphy

doi:10.1016/j.ajur.2019.07.006

Asian Journal of Urology, 2020, 7 (1): 24-28 doi: 10.1016/j.ajur.2019.07.006

Original Articles

Absence of asymptomatic unruptured renal artery pseudoaneurysm on contrast-enhanced computed tomography after robot-assisted partial nephrectomy without parenchymal renorrhaphy

Yoichiro Tohi^a,*(

),Shiori Murata^a,Noriyuki Makita^a,Issei Suzuki^a,Masashi Kubota^a,Yoshio Sugino^a,Koji Inoue^a,Hiroyuki Ueda^b,Mutsushi Kawakita^a

^a Department of Urology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminami-cho, Chuo-ku, Kobe City, Japan
^b Department of Diagnostic Radiology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminami-cho, Chuo-ku, Kobe City, Japan

Abstract
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Abstract

Objective: To assess the incidence of asymptomatic unruptured renal artery pseudoaneurysm (RAP) on contrast-enhanced computed tomography (CE-CT) after robot-assisted partial nephrectomy (RAPN) without parenchymal renorrhaphy. Methods: From May 2016 to December 2017, 78 patients underwent RAPN for renal tumors. Inner suture was performed in the opened collecting system or renal sinus, whereas parenchymal renorrhaphy was not. For hemostasis, the soft coagulation system was used, and absorbable hemostats were placed on the resection bed. CE-CT was carried out within 7 days after surgery. Data on these patients were prospectively collected. A single radiologist determined the diagnosis of RAP. Results: Median (range) data were as follows: Patient age, 65 (19-82) years; radiographic tumor size, 30 (12-95) mm; operating time, 166 (102-294) min; warm ischemic time, 16 (7-67) min; and blood loss, 15 (0-4450) mL. One patient (1.6%) required a perioperative blood transfusion. No patient required conversion to open surgery or nephrectomy. CE-CT was carried out at median 6 (3-7) days after surgery. CE-CT showed no RAP development in all 61 patients. Urinary leakage was not observed. One patient had acute cholecystitis, a postoperative complication classified as Clavien-Dindo grade higher than 3, which was treated with cholecystectomy. Positive surgical margin was identified in four patients (6.6%). Conclusion: RAPN using soft coagulation and absorbable hemostats without renorrhaphy appears to be feasible and safe. Our technique could eliminate the risk of RAP.

Key words： Pseudoaneurysm Partial nephrectomy Robot-assisted Renorrhaphy

Received: 19 June 2018 Available online: 08 October 2019

Corresponding Authors: Yoichiro Tohi E-mail: yoto716yotoyoto@gmail.com

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	Yoichiro Tohi
	Shiori Murata
	Noriyuki Makita
	Issei Suzuki
	Masashi Kubota
	Yoshio Sugino
	Koji Inoue
	Hiroyuki Ueda
	Mutsushi Kawakita

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Cite this article:

Yoichiro Tohi,Shiori Murata,Noriyuki Makita, et al. Absence of asymptomatic unruptured renal artery pseudoaneurysm on contrast-enhanced computed tomography after robot-assisted partial nephrectomy without parenchymal renorrhaphy[J]. Asian Journal of Urology, 2020, 7(1): 24-28.

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http://www.ajurology.com/EN/10.1016/j.ajur.2019.07.006 OR http://www.ajurology.com/EN/Y2020/V7/I1/24

Patients' characteristics.

Perioperative outcomes.

Pathological reports.

Details of 30 days postoperative complications by events.

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