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K. Omae, T. Kondo, T. Takagi, S. Morita, Y. Hashimoto, Hirohito Kobayashi, J. Iizuka, T. Nozaki, Kazuhiko Yoshida, K. Tanabe (2015)
Renal sinus exposure as an independent factor predicting asymptomatic unruptured pseudoaneurysm formation detected in the early postoperative period after minimally invasive partial nephrectomyInternational Journal of Urology, 22
C. Netsch, R. Brüning, T. Bach*, A. Gross (2010)
Management of renal artery pseudoaneurysm after partial nephrectomyWorld Journal of Urology, 28
M. Simmons, C. Weight, I. Gill (2009)
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G. Ploussard, R. Haddad, Oleg Loutochin, Rahul Bera, T. Cabrera, Nouf Malibari, E. Scarlata, V. Derbekyan, F. Bladou, M. Anidjar (2015)
A combination of hemostatic agents may safely replace deep medullary suture during laparoscopic partial nephrectomy in a pig model.The Journal of urology, 193 1
Samay Jain, T. Nyirenda, J. Yates, R. Munver (2013)
Incidence of renal artery pseudoaneurysm following open and minimally invasive partial nephrectomy: a systematic review and comparative analysis.The Journal of urology, 189 5
Renal artery pseudoaneurysm is a rare but life-threatening condition. Its incidence is higher after minimally invasive partial nephrectomy (PN) than after the open approach. We reported a case of a renal artery pseudoaneurysm occurred about four months after a clampless laparoscopic PN. A 49-year-old female underwent a clampless laparoscopic PN for a right renal tumor with high surgical complexity. The patient experienced an intraoperative blood loss from renal bed and the surgeons performed a deep medullary absorbable suture. Three months after surgery the patient underwent a renal ultrasonography with good results. The patient came to our emergency department 115 days after surgery with a hypovolemic shock stage 3. Her CT scan showed a pseudoaneurysm of a lower pole vessel of the right kidney. She underwent a superselective embolization of the segmental renal artery. The surgical complexity of the tumor, the anatomical relationships with the renal sinus and the deep medullary suture could be responsible for the development of the pseudoaneurysm. The authors presented an unusual case of a very late detected pseudoaneurysm of a renal vessel, suggesting that all very complex renal tumors removed with a minimally invasive technique should be followed up closely at least during the first six-months in order to early detect this major complication.
Current Urology – Karger
Published: Jan 1, 2017
Keywords: Partial nephrectomy; Renal artery pseudoaneurysm; Hyperselective embolization
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