Because most RCCs now are diagnosed in an early stage,
partial nephrectomy has become the more frequent operation in many centers already [1].
In laparoscopic partial nephrectomy (LPN),
the smaller incisions and the reduced risk of haemorrhage lead to smaller scars,
less pain,
and shorter recovery times compared to the open partial nephrectomy (OPN) [2,
3].
Disease-free survival rates are similar between partial and radical nephrectomy in these patients [4].
However,
in comparison to OPN,
LPN has a longer and shallow learning curve for the urologist with a definite disadvantage being lack of depth and tactile perception,
along with limited range of movement at the surgical site.
In order to overcome these difficulties,
some experts advocate robotic laparoscopic partial nephrectomy using the daVinci robotic system [5].
According to the 2006 European Association of Urology guidelines,
laparoscopic radical nephrectomy is considered a standard of care for the treatment of renal cell carcinoma (RCC).
However,
the minimally invasive technique of LPN does not necessarily correlate with minimal risk for complications,
as LPN has been associated with higher complication rates [6-10].
By the literature review,
most of these complications occurred one to four weeks after surgery,
and there are a few reports about the vascular complications in early postoperative phase (within a week after the LPN).
These postoperative vascular complications,
especially the renal artery pseudoaneurysm (RAP),
resulted in serious symptoms and might sometimes result in death: we therefore attempt to screen the vascular complications early in the hospitalized perioperative period and treat them.
Therefore we routinely undergo high-definition three-dimensional CT in an early postoperative period (perioperative 3D-CT).
Generally,
postoperative follow-up for renal cell carcinoma (RCC),
the CT imaging of 3 phases including unenhanced phase is used with slice thickness of approximately 5 mm [11].
Also in our hospital,
follow-up CT has been performed using routine CT imaging with slice thickness of 5 mm,
including unenhanced,
early and delayed phase images to survey the postoperative recurrence in nephrectomy cases.
The purpose of this study was to elucidate the frequency of the early vascular complications after the partial nephrectomy by using perioperative 3D-CT,
the natural history of RAPs by using follow-up 3D-CT,
the difference in detection rates of the early vascular complications among the reconstruction methods of perioperative 3D-CT and the significance of perioperative 3D-CT.