Delayed proximal ureteric stricture formation after complex partial nephrectomy.
Publication/Presentation Date
2-1-2012
Abstract
OBJECTIVE: • To report and review our incidence of delayed ureteric stricture (US) after complex nephron-sparing surgery (NSS).
PATIENTS AND METHODS: • Using our institutional kidney cancer database, we identified 720 patients who underwent NSS from 1 January 2000 until 31 December 2010 and identified eleven (1.5%) patients with a delayed US. • Patient and tumour characteristics were reviewed.
RESULTS: • Median (range) tumour size and RENAL nephrometry score was 4.1 (2-7.2) cm and 10p (4-11p), respectively. • There were eight of 10 solitary tumours (80%) located in the lower or mid-pole of the kidney. • There were eight of 11 patients with delayed US (72.7%) who experienced a postoperative urinary leak. • There were two of 11 (18.2%) patients who experienced a postoperative retroperitoneal haemorrhage, with one of these patients requiring selective embolization. • All US were in the upper third of the ureter and were diagnosed at a minimum of 10 weeks postoperatively (median 154 days, range 70-400 days).
CONCLUSIONS: • US formation is an uncommon and under-reported event after complex NSS. • Risk factors appear to include tumour complexity, imperative indications, mid- or lower pole location, postoperative urinary leak and haemorrhage. • Although uncommon, postoperative US can occur after NSS for complex renal masses, necessitating patient counselling and diligent postoperative surveillance.
Volume
109
Issue
4
First Page
539
Last Page
543
ISSN
1464-410X
Published In/Presented At
Reyes, J. M., Canter, D. J., Sirohi, M., Simhan, J., Smaldone, M. C., Teper, E., Kutikov, A., Chen, D. Y., & Uzzo, R. G. (2012). Delayed proximal ureteric stricture formation after complex partial nephrectomy. BJU international, 109(4), 539–543. https://doi.org/10.1111/j.1464-410X.2011.10395.x
Disciplines
Medicine and Health Sciences
PubMedID
21733077
Department(s)
Department of Surgery
Document Type
Article