Delayed hemorrhage after partial nephrectomy: 5 cases report
10.3760/cma.j.issn.1000-6702.2010.09.003
- VernacularTitle:肾部分切除术后迟发性出血原因分析及防治
- Author:
Hang WANG
;
Guomin WANG
;
Jianming GUO
;
Lian SUN
;
Zongming LIN
;
Li ZHANG
;
Tongyu ZHU
;
Ming XU
;
Yongkang ZHANG
- Publication Type:Journal Article
- Keywords:
Kidney neoplasms;
Nephrectomy;
Postoperative hemorrhage
- From:
Chinese Journal of Urology
2010;31(9):585-587
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the etiology and management of hemorrhage after partial nephrectomy because of renal cancer. Methods Of the 382 cases performed partial nephrectomy during a 10-year period, 5 patients(1.3%) had postoperative hemorrhage because of a renal artery pseudoaneurysm. The ages of these patients were from 42 to 63 years. All the tumors were malignant with an average diameter of 2. 8 cm. The renal pedicle was blocked in 2 cases with tumor size larger than 3 cm. The kidney was reconstructed with interrupted 0 chromic sutures in "8"or "U" style. Delayed postoperative hemorrhage occurred from 6 days to 3 months. The blood loss was from 1000 to 4500mi. Shock or lower blood pressure occurred in 3 patients. Nephrectomy was performed in 1 patient and selective angiographic embolization was performed in other 4 cases. Results Angiography revealed renal artery pseudoaneurysm in all 5 cases at the third (4 cases) or fourth branch(1 patient).Percutaneous embolization was successful in 4 patients. Four cases were followed up for 2 to 9 years without complication. Conclusions Delayed postoperative hemorrhage following partial nephrectomy is an uncommon but potentially life-threatening complication. Super-selective angiographic embolization could be the first choice of treatment.
