Review the different complications after partial nephrectomy. Show the ability of the images techniques in their diagnosis. Describe the various management options.
For patients with localized renal cell carcinoma (RCC) and select patients with advanced RCC,
surgery can be curative. Renal cell carcinoma (RCC): Responsible for 80 to 85 percent of all primary renal neoplasms. In Europe in 2012,
there were 115,000 cases and 49,000 deaths. Most are incidental findings due to the increasing development and availability of imaging techniques. For patients undergoing definitive surgical treatment for RCC,
a radical nephrectomy (RN) or partial nephrectomy (PN)...
Findings and procedure details
1. Normal postoperative imaging: The postoperative kidney commonly has a more posterior retroperitoneal location (closer to theposterior abdominal wall). Fig. 1 The appearance of the postoperative kidney depends on the size and the location of the resected tumor.After resection of small peripheral tumor,
a wedgeshaped defect in the renal parenchyma is seen at CT and MR imaging. Fig. 2 In some cases,
the surgeon may pack perinephric fat into the surgical bed to help achieve hemostasis.
Familiarity with the normal postoperative imaging as well as the features that are indicative of complications allows accurate diagnosis and appropiate management.
Van Poppel H,
Da Pozzo L,
randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma.
Eur Urol 2011; 59:543. Patard JJ,
Safety and efficacy efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience.
J Urol 2004; 171:2181. Pahernik S,
Nephron sparing surgery...