Learning objectives
-To review common hemostatic agents and tissue sealants used in partial nephrectomy to achieve parenchymal hemostasis
-To demonstrate different magnetic resonance appearances of common hemostatic agents and tissue sealants after partial nephrectomy
-To evaluate changes in appearances of hemostatic agents and tissue sealants in the follow-up period
Background
Partial nephrectomy (PN) is currently the treatment of choice for small renal masses to avoid the possible renal function impairment that can result from radical nephrectomy [1].
Hemostasis is a key factor during PN.
When the wall of a blood vessel is injured,
several sequential reactions occur to produce fibrin and form a stable hemostatic plug.
Those reactions involve;
(1) Vessel constriction to reduce blood flow
(2) Adherence of circulating platelets to the vessel wall at the injury site
(3) Platelet activation and aggregation under...
Findings and procedure details
We reviewed our institutional data base for patients with partial nephrectomy operation including both open PN and laparoscopic PN between January 2013 and June 2017.
Of the overall 38 patients (age range 37-76 years-old) with PN,
32 patients had pathological diagnosis of renal cell carcinoma and others had benign lesions including oncocytoma and hydatid cyst.
In all patients one or more hemostatic agent or tissue sealant were used for promoting hemostasis.
All patients were followed-up via magnetic resonance imaging (MRI) between 3-36 months.
Also,
4...
Conclusion
Knowledge of MR imaging features of hemostatic agents and tissue sealants after PN and changes in the follow-up period is important in interpreting postoperative MR imaging examinations since those agents may mimic tumor recurrence.
Personal information
Hilal Sahin,
MD
Tepecik Training and Research Hospital,
Department of Radiology,
Izmir,
Turkey
Asli Irmak Biranci,
MD
Tepecik Training and Research Hospital,
Department of Radiology,
Izmir,
Turkey
Aysun Cakir,
MD
Tepecik Training and Research Hospital,
Department of Radiology,
Izmir,
Turkey
Yeliz Pekcevik,
MD,
Associate Professor
Tepecik Training and Research Hospital,
Department of Radiology,
Izmir,
Turkey
Erdem Kisa,
MD
Tepecik Training and Research Hospital,
Department of Urology,
Izmir,
Turkey
Zafer Kozacıoglu,
MD,
Associate Professor
Tepecik Training and Research Hospital,
Department of Urology,
Izmir,
Turkey
References
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Computed tomography imaging features and changes in hemostatic agents after laparoscopic partial nephrectomy.
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A review of current hemostatic agents and tissue sealants used in laparoscopic partial nephrectomy.
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Topical hemostatic agents in surgical practice.
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4. Young ST,
Paulson EK,
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