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ECR 2018 / C-2456
Magnetic resonance imaging features of hemostatic agents and tissue sealants after partial nephrectomy
Congress: ECR 2018
Poster No.: C-2456
Type: Educational Exhibit
Keywords: Kidney, MR, MR-Diffusion/Perfusion, Diagnostic procedure, Surgery, Haemorrhage, Biological effects
Authors: H. Sahin, A. I. Biranci, A. Cakir, Y. Pekcevik, E. Kısa, Z. Kozacioglu; Izmir/TR
DOI:10.1594/ecr2018/C-2456

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 control of several enzymatic processes [2].

 

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 [2]. 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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