Analysis and treatment of delayed hemorrhage after partial nephrectomy

Abstract

Objective: To explore the causes of delayed hemorrhage after partial nephrectomy and its prevention and treatment methods.

Methods: Clinical data for 64 cases of patients who received partial nephrectomy from August of 2010 to December of 2015 were retrospectively analyzed; whereas, 3 cases of patients (4.7%) had delayed hemorrhage, including 1 case of male patient and 2 cases of female patients. Then, compared them with patients with no hemorrhage to explore the risk factors for hemorrhage after partial nephrectomy.

Results: Three cases of patients showed a large volume of gross hematuria in 7-22 days (the average was 16.3 days) after partial nephrectomy, with blood pressure and hemoglobin (HGB) decreased. 2 cases of patients with hemorrhage were given blood transfusion and conservative treatment, and patients’ conditions were improved obviously. The other patient was given superselective renal artery embolization (SRAE), with renal arteriography indicating the presence of pseudoaneurysm. Hematuria disappeared after surgery. In comparison with the non-hemorrhage group, warm ischemia time was longer in the hemorrhage group, and the difference was of statistical significance (p < .05).

Conclusions: Hemorrhage occurred after partial nephrectomy is mostly delayed. Once the type of complications happens, it is required to provide a timely treatment. Super-selective renal artery embolization (SRAE) is a safe and effective treatment method for hemorrhage after partial nephrectomy.