The influence of renal nephrometry score on pre‑ruptured pseudoaneurysm formation in early postoperative period after minimally invasive partial nephrectomy


Authors: T. Kondo;  K. Omae;  T. Takagi;  S. Morita;  Y. Hashimoto;  H. Kobayashi;  J. Iizuka;  K. Yoshida;  K. Tanabe
Published in: Urol List 2014; 12(2): 58-64

Overview

Objectives:
Renal artery pseudoaneurysm (RAP) can be a life threatening complication after partial nephrectomy. We investigated the incidence of unruptured RAP detected by 3- dimensional computed tomography arteriography (CTA) in the early period after minimally invasive partial nephrectomy (MIPN), including laparoscopic and robotic partial nephrectomy. We also examined the usefulness of nephrometry scoring system to predict the occurrence of RAP.

Methods:
From February 2012 to November 2013, 101 patients underwent MIPN for renal masses. CTA was performed 3– 4 days after surgery, and the radiologists made a dia­gnosis of RAP in the blinded manner. The factors influencing the occurrence of RAP were analyzed with the logistic regression model.

Results:
The incidence of RAP was unexpectedly high at 21.7% when detected by CTA in the early period after MIPN. The RAP group showed a significantly larger tumor size (p = 0.02) and a significantly higher N component score (p = 0.01) compared to the No- RAP group. However, Neither the sum of nephrometry score nor each component showed significant influence on the occurrence of RAP according to the multivariate analysis. Tumor size was the only significant independent factor to predict the occurrence of RAP after MIPN.

Conclusions:
The N component of the nephrometry scoring system is a significant predictor for RAP by the univariate analysis, but not by the multivariate analysis. The N component of the nephrometry scoring system may be referred to as one of the factors predicting the occurrence RAP.

Key words:
renal neoplasms nephrectomy, aneurysm, false, laparoscopy, robotics,


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