Renovascular Hypertension as a Rare Complication of Laparoscopic Extraperitoneal Paraaortic Lymphadenectomy

Safety and Feasibility Analysis of Laparoscopic Lymphadenectomy in Pelvic Gynecologic Malignancies: A Prospective Study

“…The rate of late-postoperative complication was 3.6% (13 cases); the most frequent ones were symptomatic lymphocele and lymphedema (6 and 5 patients, respectively) followed by 1 case of asymptomatic incisional hernia and 1 case of renovascular hypertension (the latter described elsewhere 10 ). Only 2 patients with lymphocele needed surgical drainage; the remaining 4 cases were treated with percutaneous drainage.…”

“…This outcome could be somehow expected considering that lymphadenectomy is essentially a vascular procedure involving dissection of lymph nodes in close contact with large blood vessels and that vascular anomalies in the para-aortic region are common, identified in more than 30% of patients. 10,13 In other published series, major vascular injury was reported in approximately 1% to 10% of cases. 11,14 Remarkably, conversion to laparotomy to manage bleeding was only necessary in 1 case at the beginning of the study, whereas the other 2 cases of vascular trauma were successfully managed with laparoscopically applied bipolar energy, vascular clips, and hemostasis-promoting agents.…”

Encountering the accessory polar renal artery during retroperitoneal lymphadenectomy

“…6 In addition, cases of reno-vascular hypertension due to polar artery injury have been reported in the literature. 7 Any vascular anomalies were reported in the preoperative imaging tests performed in both cases. For this reason, it is very important that gynecologist oncologists surgical experience and know the retroperitoneal vascular anatomy well, because of the possibility of encountering vascular variations.…”

“…Because of the APRA is functional, it is extremely important to be careful with vascular injuries, to prevent ischemic damage and not to cause kidney failure complications 6 . In addition, cases of reno‐vascular hypertension due to polar artery injury have been reported in the literature 7 . Any vascular anomalies were reported in the preoperative imaging tests performed in both cases.…”