|ECR 2018 / C-2456|
|Magnetic resonance imaging features of hemostatic agents and tissue sealants after partial nephrectomy|
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 .
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 control of several enzymatic processes .
Hemostatic agents and tissue sealants are now being used more commonly during PN as an adjuvant to suturing. They act by imitating, promoting or by-passing specific steps of the coagulation cascade ( Fig. 1 ).
The most common hemostatic agents used in minimally invasive urologic surgeries are oxidized regenerated methylcellulose, gelatin-based sealant, glutaraldehyde-based adhesives, human fibrinogen and thrombin fleece, absorbable hemostatic gelatin sponge and hemostatic sealant powder . In addition, autologous perirenal fat and Hem-O-lok clips are also used to achieve hemostasis.
The different composition of those agents causes variable radiological appearances which may confound the interpretation of findings in the follow-up after PN.
We aim to review magnetic resonance (MR) imaging features associated with hemostatic agents and tissue sealants using our cohort.
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