Interventional Management of Renal Bleeding after Partial Nephrectomy

Abstract

Angiographic embolization in patients with renal hemorrhage after PN is feasible and has a high success rate. The procedure might facilitate avoidance of nephrectomy.

Risk factors and clinical management of haemorrhage after open nephron‐sparing surgery

“…However, in cohort studies control of bleeding is reported in 80-100% (Table 6). Our success rates are comparable to other case series [11], but appear to fall within the lower range. Some variance is explained by the generally few cases.…”

“…Moreover, monitoring should be prolonged if any precursor of a complicated course is evident, especially in high-risk cases. Later manifestations of bleeding tend to be symptomatic [11] and were observed up to 3 weeks after NSS in the present study. Further diagnostic measures include contrastenhanced CT of the abdomen and, if an active bleeding site is evident, digital subtraction angiography.…”

“…Bleeding was controlled by TAE in two of six patients primarily and in further two after a second intervention. We present one of the largest case series to date showing that TAE is an effective rescue strategy for bleeding after NSS (Table 6) [11,[14][15][16][17][18]. Several case reports [19][20][21][22][23][24][25][26] show an excellent outcome, but there might be publication bias.…”

Integration of laparoscopic partial nephrectomy into an Australian public hospital: three‐year follow‐up of our initial 50 cases

“…[ 28,30 -32 ] . Delayed bleeding can be managed angiographically in most cases, but in rare instances nephrectomy may be required [ 28,33 ] . The present haemorrhage incidence of 4% and transfusion incidence of 2% were lower than many published series.…”

Radiologisch-interventionelle superselektive Embolisation - universeller Einsatz bei verschiedensten Blutungskomplikationen nach renaler Chirurgie

“…Die TAE findet ferner erfolgreiche Anwendung bei der Beherrschung von renalen Blutungskomplikationen nach offenen oder laparoskopischen Operationen wie der perkutanen Nephrolitholapaxie oder der offenen bzw. laparoskopischen Nierentumorenukleation [2,8,10,12]. Die palliative Embolisation von großen Nierenzellkarzinomen muss in diesem Zusammenhang genannt werden, streng genommen handelt es sich jedoch nicht um ein superselektives Verfahren [7].…”