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Published in: International Urology and Nephrology 6/2019

01-06-2019 | Nephrectomy | Urology - Original Paper

Magnetic resonance imaging characteristics and changes in hemostatic agents after partial nephrectomy

Authors: Erdem Kisa, Hilal Sahin, Ozgür Cakmak, Cem Yucel, Gokhan Koc, Zafer Kozacioglu, Yusuf Ozlem Ilbey

Published in: International Urology and Nephrology | Issue 6/2019

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Abstract

Purpose

To evaluate the characteristics of images generated by magnetic resonance imaging (MRI) and changes in the mass-like lesion (MLL) during the follow-up of patients who underwent partial nephrectomy (PN) with the intra-operative use of hemostatic agents (HAs).

Methods

The records of patients who had undergone PN in our clinic due to renal mass between January 2013 and August 2018 were retrospectively reviewed. Our study included 47 patients who were administered one or more HAs during the PN and who received diffusion and dynamic MRI at the post-operative 2nd/4th Queryand 12th month.

Results

MLL is defined as T2 heterogeneous, intermediate-signal intensity bolster-related mass with a pseudocapsule in the renal parenchymal defect. When we looked at the morphological changes of MLL, the mean largest axial dimensions of masses were 27.3 (range 12.2–44.7) mm in the first follow-up period (2nd/4th months) and 21.2 (range 11–44.7) mm in the 12th month follow-up period. The average change in size of MLL was − 0.66 mm/month. We did not see any significant relationship between observation of MLL in the post-operative follow-up MRI images and the use of HAs such as Surgicel®, Spongostan®, and autologous fatty tissue as well as the amount of the agents used in PN operations (p = 0.405, p = 0.159, respectively).

Conclusions

The distinction of MLL causing bolster-related mass and granulomatosis tissue from relapse/recurrence can be made based on the change in mass size observed in the MR images and image characteristics.
Literature
1.
go back to reference Ljungberg B, Bensalah K, Canfield S et al (2015) EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol 67:913CrossRefPubMed Ljungberg B, Bensalah K, Canfield S et al (2015) EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol 67:913CrossRefPubMed
2.
go back to reference Van Poppel H, Kilen K, Baert L (2001) Incidental renal cell carcinoma and nephron sparing surgery. Curr Opin Urol 11:281CrossRefPubMed Van Poppel H, Kilen K, Baert L (2001) Incidental renal cell carcinoma and nephron sparing surgery. Curr Opin Urol 11:281CrossRefPubMed
3.
go back to reference Carrion DM, Y Gregorio SA, Rivas JG et al (2017) The role of hemostatic agents in preventing complications in laparoscopic partial nephrectomy. Cent Eur J Urol 70(4):362–367 Carrion DM, Y Gregorio SA, Rivas JG et al (2017) The role of hemostatic agents in preventing complications in laparoscopic partial nephrectomy. Cent Eur J Urol 70(4):362–367
4.
go back to reference Breda A, Stepanian SV, Lam JS et al (2007) Use of haemostatic agents and glues during laparoscopic partial nephrectomy: a multi-institutional survey from the United States and Europe of 1347 cases. Eur Urol 52:798–803CrossRefPubMed Breda A, Stepanian SV, Lam JS et al (2007) Use of haemostatic agents and glues during laparoscopic partial nephrectomy: a multi-institutional survey from the United States and Europe of 1347 cases. Eur Urol 52:798–803CrossRefPubMed
5.
go back to reference Lang H, Mouracade P, Gimel P et al (2014) National prospective study on the use of local haemostatic agents during partial nephrectomy. BJU Int 113:E56–E61CrossRefPubMed Lang H, Mouracade P, Gimel P et al (2014) National prospective study on the use of local haemostatic agents during partial nephrectomy. BJU Int 113:E56–E61CrossRefPubMed
6.
go back to reference Emilia M, Luca S, Francesca B et al (2011) Topical hemostatic agents in surgical practice. Transfus Apher Sci 45(3):305–311CrossRefPubMed Emilia M, Luca S, Francesca B et al (2011) Topical hemostatic agents in surgical practice. Transfus Apher Sci 45(3):305–311CrossRefPubMed
7.
go back to reference Galanakis I, Vasdev N, Soomro N (2011) A review of current hemostatic agents and tissue sealants used in laparoscopic partial nephrectomy. Rev Urol 13(3):131–138PubMedPubMedCentral Galanakis I, Vasdev N, Soomro N (2011) A review of current hemostatic agents and tissue sealants used in laparoscopic partial nephrectomy. Rev Urol 13(3):131–138PubMedPubMedCentral
8.
go back to reference Paka B, Bossemeyer R, Tourojman M et al (2017) Holding strength of a Hem-o-lok/Lapra-Ty clip combination on sutures used during partial nephrectomy. Urology 107:138–143CrossRefPubMed Paka B, Bossemeyer R, Tourojman M et al (2017) Holding strength of a Hem-o-lok/Lapra-Ty clip combination on sutures used during partial nephrectomy. Urology 107:138–143CrossRefPubMed
9.
go back to reference Thompson T, Ng CF, Tolley D (2003) Renal parenchymal hemostatic aids: glues and things. Curr Opin Urol 13:209–214CrossRefPubMed Thompson T, Ng CF, Tolley D (2003) Renal parenchymal hemostatic aids: glues and things. Curr Opin Urol 13:209–214CrossRefPubMed
10.
go back to reference Williamson TJ, Pearson JR, Ischia J et al (2016) Guideline of guidelines: follow-up after nephrectomy for renal cell carcinoma. BJU Int. 117(4):555–562CrossRefPubMed Williamson TJ, Pearson JR, Ischia J et al (2016) Guideline of guidelines: follow-up after nephrectomy for renal cell carcinoma. BJU Int. 117(4):555–562CrossRefPubMed
11.
go back to reference Israel GM, Hecht E, Bosniak MA (2006) CT and MR imaging of complications of partial nephrectomy. Radiographics 26(5):1419–1429CrossRefPubMed Israel GM, Hecht E, Bosniak MA (2006) CT and MR imaging of complications of partial nephrectomy. Radiographics 26(5):1419–1429CrossRefPubMed
12.
go back to reference Kim TS, Park JG, Kang H et al (2016) Computed tomography imaging features and changes in hemostatic agents after laparoscopic partial nephrectomy. J Endourol 30(9):950–957CrossRefPubMed Kim TS, Park JG, Kang H et al (2016) Computed tomography imaging features and changes in hemostatic agents after laparoscopic partial nephrectomy. J Endourol 30(9):950–957CrossRefPubMed
13.
go back to reference Lee MS, Oh YT, Han WK et al (2007) CT findings after nephron-sparing surgery of renal tumors. AJR Am J Roentgenol 189(5):W264–W271CrossRefPubMed Lee MS, Oh YT, Han WK et al (2007) CT findings after nephron-sparing surgery of renal tumors. AJR Am J Roentgenol 189(5):W264–W271CrossRefPubMed
14.
go back to reference Young ST, Paulson EK, McCann RL et al (1993) Appearance of oxidized cellulose (Surgicel) on postoperative CT scans: similarity to postoperative abscess. AJR 160:275–277CrossRefPubMed Young ST, Paulson EK, McCann RL et al (1993) Appearance of oxidized cellulose (Surgicel) on postoperative CT scans: similarity to postoperative abscess. AJR 160:275–277CrossRefPubMed
15.
go back to reference Pai D, Willatt JM, Korobkin M et al (2010) CT appearances following laparoscopic partial nephrectomy for renal cell carcinoma using a rolled cellulose bolster. Cancer Imaging 10:161–168CrossRefPubMedPubMedCentral Pai D, Willatt JM, Korobkin M et al (2010) CT appearances following laparoscopic partial nephrectomy for renal cell carcinoma using a rolled cellulose bolster. Cancer Imaging 10:161–168CrossRefPubMedPubMedCentral
16.
go back to reference Thompson RH, Boorjian SA, Lohse CM et al (2008) Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol 179:468CrossRefPubMed Thompson RH, Boorjian SA, Lohse CM et al (2008) Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol 179:468CrossRefPubMed
17.
go back to reference Antonelli A, Minervini A, Mari A et al (2015) TriMatch comparison of the efficacy of FloSeal versus TachoSil versus no hemostatic agents for partial nephrectomy: results from a large multicenter dataset. Int J Urol 22(1):47–52CrossRefPubMed Antonelli A, Minervini A, Mari A et al (2015) TriMatch comparison of the efficacy of FloSeal versus TachoSil versus no hemostatic agents for partial nephrectomy: results from a large multicenter dataset. Int J Urol 22(1):47–52CrossRefPubMed
18.
go back to reference Abu-Ghanem Y, Dotan Z, Kaver I et al (2016) The use of haemostatic agents does not impact the rate of hemorrhagic complications in patients undergoing partial nephrectomy for renal masses. Sci Rep 30(6):32376CrossRef Abu-Ghanem Y, Dotan Z, Kaver I et al (2016) The use of haemostatic agents does not impact the rate of hemorrhagic complications in patients undergoing partial nephrectomy for renal masses. Sci Rep 30(6):32376CrossRef
19.
go back to reference Pierce A, Wilson D, Wiebkin O (1987) Surgicel: macrophage processing of the fibrous component. Int J Oral Maxillofac Surg 16:338–345CrossRefPubMed Pierce A, Wilson D, Wiebkin O (1987) Surgicel: macrophage processing of the fibrous component. Int J Oral Maxillofac Surg 16:338–345CrossRefPubMed
20.
go back to reference Bailey OT, Ingraham FD (1944) Chemical, clinical, and immunological studies on the products of human plasma fractionation. XXI. The use of fibrin foam as a hemostatic agent in neurosurgery: clinical and pathological studies. J Clin Investig 23(4):591–596CrossRefPubMed Bailey OT, Ingraham FD (1944) Chemical, clinical, and immunological studies on the products of human plasma fractionation. XXI. The use of fibrin foam as a hemostatic agent in neurosurgery: clinical and pathological studies. J Clin Investig 23(4):591–596CrossRefPubMed
Metadata
Title
Magnetic resonance imaging characteristics and changes in hemostatic agents after partial nephrectomy
Authors
Erdem Kisa
Hilal Sahin
Ozgür Cakmak
Cem Yucel
Gokhan Koc
Zafer Kozacioglu
Yusuf Ozlem Ilbey
Publication date
01-06-2019
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 6/2019
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-019-02141-1

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