The role of postoperative ultrasonography in the early detection of renal artery pseudoaneurysms after robot-assisted partial nephrectomy.

Abstract

Introduction: The presence of renal artery pseudoaneurysms, a complication after robot-assisted partial nephrectomy, was evaluated by abdominal ultrasonography. The incidence of renal artery pseudoaneurysms detected by abdominal ultrasonography and the usefulness of abdominal ultrasonography for evaluation after partial nephrectomy were also examined.

Methods: A total of 73 patients who underwent robot-assisted partial nephrectomy between September 2020 and June 2023 and who underwent abdominal ultrasonography on postoperative day 7 to screen for renal pseudoaneurysms were retrospectively reviewed.

Results: Ultrasonography after partial nephrectomy showed the presence of renal artery pseudoaneurysms in 3 of 73 patients (4.1%). One of the patients with a renal artery pseudoaneurysm was diagnosed with a large, 15-mm renal artery pseudoaneurysm on postoperative day 7, followed by hematuria with blood clot on postoperative day 10, but the bleeding was stopped by vascular embolization, and the patient had a good course. Two other patients were diagnosed with 20-mm and 16-mm renal artery pseudoaneurysms on postoperative day 7;they were carefully monitored, and the pseudoaneurysms disappeared and regressed by CT or ultrasonography. One of the 73 patients in this study had an intravesical hemorrhage on the 8th postoperative day and underwent emergency embolization. The results of this study showed that renal artery pseudoaneurysms as small as 15 mm in diameter can be identified.

Conclusion: The present results suggest that screening ultrasonography is useful in identifying renal pseudoaneurysms in the early postoperative period after partial nephrectomy. J. Med. Invest. 73 : 106-110, February, 2026.