Prospective Radiographic Followup After En Bloc Ligation of the Renal Hilum

Wesley White, Frederick A. Klein, Judson Gash, W Waters

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: We determined the risk of arteriovenous fistula after en bloc ligation of the renal hilum. Materials and Methods: A prospective evaluation of all patients who underwent en bloc ligation of the renal hilum during nephrectomy for malignant disease was performed. Pertinent operative data were recorded and patients were followed for clinical evidence of arteriovenous fistula formation, including hypertension, abdominal bruit and new onset congestive heart failure. Patients with at least 12 months of followup underwent computerized tomographic arteriography to assess arteriovenous fistula formation. Results: A total of 94 patients underwent en bloc renal hilar ligation during open (43) and laparoscopic (51) nephrectomy using a 45 mm titanium endovascular stapler. Of this cohort 11 patients were lost to followup and 3 died of disease. The remaining 80 patients were followed an average of 35.2 months with no clinical evidence of arteriovenous fistula formation. Specifically there was no statistically significant difference in preoperative and postoperative blood pressure (p = 0.18 and 0.62, respectively), no evidence of abdominal bruit on examination and no new onset congestive heart failure. A total of 32 had increased serum creatinine and, therefore, they were excluded from followup computerized tomographic arteriography. Eight patients had a followup of less than 1 year and they were not yet eligible for evaluation. In the 40 patients who underwent computerized tomographic arteriography no fistulas were noted. Conclusions: Based on clinical followup and prospective radiographic evaluation there appears to be a low risk of arteriovenous fistula formation after en bloc ligation of the renal hilum using a titanium endovascular stapler.

Original languageEnglish (US)
Pages (from-to)1888-1891
Number of pages4
JournalJournal of Urology
Volume178
Issue number5
DOIs
StatePublished - Nov 1 2007
Externally publishedYes

Fingerprint

Ligation
Arteriovenous Fistula
Kidney
Angiography
Titanium
Nephrectomy
Heart Failure
Fistula
Creatinine
Blood Pressure
Hypertension
Serum

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Prospective Radiographic Followup After En Bloc Ligation of the Renal Hilum. / White, Wesley; Klein, Frederick A.; Gash, Judson; Waters, W.

In: Journal of Urology, Vol. 178, No. 5, 01.11.2007, p. 1888-1891.

Research output: Contribution to journalArticle

@article{cf1d9afe979548fcab1096329c643179,
title = "Prospective Radiographic Followup After En Bloc Ligation of the Renal Hilum",
abstract = "Purpose: We determined the risk of arteriovenous fistula after en bloc ligation of the renal hilum. Materials and Methods: A prospective evaluation of all patients who underwent en bloc ligation of the renal hilum during nephrectomy for malignant disease was performed. Pertinent operative data were recorded and patients were followed for clinical evidence of arteriovenous fistula formation, including hypertension, abdominal bruit and new onset congestive heart failure. Patients with at least 12 months of followup underwent computerized tomographic arteriography to assess arteriovenous fistula formation. Results: A total of 94 patients underwent en bloc renal hilar ligation during open (43) and laparoscopic (51) nephrectomy using a 45 mm titanium endovascular stapler. Of this cohort 11 patients were lost to followup and 3 died of disease. The remaining 80 patients were followed an average of 35.2 months with no clinical evidence of arteriovenous fistula formation. Specifically there was no statistically significant difference in preoperative and postoperative blood pressure (p = 0.18 and 0.62, respectively), no evidence of abdominal bruit on examination and no new onset congestive heart failure. A total of 32 had increased serum creatinine and, therefore, they were excluded from followup computerized tomographic arteriography. Eight patients had a followup of less than 1 year and they were not yet eligible for evaluation. In the 40 patients who underwent computerized tomographic arteriography no fistulas were noted. Conclusions: Based on clinical followup and prospective radiographic evaluation there appears to be a low risk of arteriovenous fistula formation after en bloc ligation of the renal hilum using a titanium endovascular stapler.",
author = "Wesley White and Klein, {Frederick A.} and Judson Gash and W Waters",
year = "2007",
month = "11",
day = "1",
doi = "10.1016/j.juro.2007.07.042",
language = "English (US)",
volume = "178",
pages = "1888--1891",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Prospective Radiographic Followup After En Bloc Ligation of the Renal Hilum

AU - White, Wesley

AU - Klein, Frederick A.

AU - Gash, Judson

AU - Waters, W

PY - 2007/11/1

Y1 - 2007/11/1

N2 - Purpose: We determined the risk of arteriovenous fistula after en bloc ligation of the renal hilum. Materials and Methods: A prospective evaluation of all patients who underwent en bloc ligation of the renal hilum during nephrectomy for malignant disease was performed. Pertinent operative data were recorded and patients were followed for clinical evidence of arteriovenous fistula formation, including hypertension, abdominal bruit and new onset congestive heart failure. Patients with at least 12 months of followup underwent computerized tomographic arteriography to assess arteriovenous fistula formation. Results: A total of 94 patients underwent en bloc renal hilar ligation during open (43) and laparoscopic (51) nephrectomy using a 45 mm titanium endovascular stapler. Of this cohort 11 patients were lost to followup and 3 died of disease. The remaining 80 patients were followed an average of 35.2 months with no clinical evidence of arteriovenous fistula formation. Specifically there was no statistically significant difference in preoperative and postoperative blood pressure (p = 0.18 and 0.62, respectively), no evidence of abdominal bruit on examination and no new onset congestive heart failure. A total of 32 had increased serum creatinine and, therefore, they were excluded from followup computerized tomographic arteriography. Eight patients had a followup of less than 1 year and they were not yet eligible for evaluation. In the 40 patients who underwent computerized tomographic arteriography no fistulas were noted. Conclusions: Based on clinical followup and prospective radiographic evaluation there appears to be a low risk of arteriovenous fistula formation after en bloc ligation of the renal hilum using a titanium endovascular stapler.

AB - Purpose: We determined the risk of arteriovenous fistula after en bloc ligation of the renal hilum. Materials and Methods: A prospective evaluation of all patients who underwent en bloc ligation of the renal hilum during nephrectomy for malignant disease was performed. Pertinent operative data were recorded and patients were followed for clinical evidence of arteriovenous fistula formation, including hypertension, abdominal bruit and new onset congestive heart failure. Patients with at least 12 months of followup underwent computerized tomographic arteriography to assess arteriovenous fistula formation. Results: A total of 94 patients underwent en bloc renal hilar ligation during open (43) and laparoscopic (51) nephrectomy using a 45 mm titanium endovascular stapler. Of this cohort 11 patients were lost to followup and 3 died of disease. The remaining 80 patients were followed an average of 35.2 months with no clinical evidence of arteriovenous fistula formation. Specifically there was no statistically significant difference in preoperative and postoperative blood pressure (p = 0.18 and 0.62, respectively), no evidence of abdominal bruit on examination and no new onset congestive heart failure. A total of 32 had increased serum creatinine and, therefore, they were excluded from followup computerized tomographic arteriography. Eight patients had a followup of less than 1 year and they were not yet eligible for evaluation. In the 40 patients who underwent computerized tomographic arteriography no fistulas were noted. Conclusions: Based on clinical followup and prospective radiographic evaluation there appears to be a low risk of arteriovenous fistula formation after en bloc ligation of the renal hilum using a titanium endovascular stapler.

UR - http://www.scopus.com/inward/record.url?scp=35148830267&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=35148830267&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2007.07.042

DO - 10.1016/j.juro.2007.07.042

M3 - Article

VL - 178

SP - 1888

EP - 1891

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 5

ER -