Assessing Renal Function Recovery Following Treatment for Post-Robot-Assisted Partial Nephrectomy Renal Artery Pseudoaneurysm.

Abstract

Introduction: To evaluate the impact of the treatment for renal artery pseudoaneurysm (RAP) on long-term renal function after robot-assisted partial nephrectomy (RAPN). Materials: We retrospectively reviewed 581 consecutive RAPNs performed by a single surgeon from February 2008 to February 2022. We evaluated patient variables, postoperative complications, and renal function at postoperative day one, 1 month, and 6 months after RAPN. Renal function was defined as estimated glomerular filtration rate (eGFR) based on the chronic kidney disease epidemiology collaboration Cr 2009 equation. We utilized the Fisher's exact test and Kruskal-Wallis rank sum test to analyze our data through categorical and continuous variables. Results: Twenty-one patients (3.61%) developed a symptomatic RAP after RAPN that was treated with Interventional Radiology embolization. Patients with a RAP had a median age of 61.8 years (IQR: 53.5-69.7), median preoperative eGFR of 83.9 (IQR: 69.5-85.2), median BMI of 29.4 (IQR: 25.4-33.1), and median mass size of 3 cm (IQR: 2.5-4.2). There was no statistical difference in baseline characteristics between patients with RAP and patients without RAP. Patients with RAP had a longer length of stay (LOS) (3.0 IQR: 2.0-4.0 vs 2.0 IQR: 2.0-3.0). Patients with a RAP had a larger change in absolute eGFR value based on the difference from baseline to 1 month and 6 months (1 month: 20.5 vs 11.2, p < 0.001; 6 months: 18.1 vs 10.4, p = 0.001). RAP patients were also less likely to be within 10% of pre-RAPN levels (1 month: 24% vs 49%, p = 0.021; 6 months: 18% vs 47%, p = 0.016). Conclusions: Patients treated for RAP post-RAPN had a decrease in renal function recovery at 1 month and 6-month intervals compared to patients not requiring post-RAPN RAP treatment.