Послеоперационные осложнения

Renal cancer. Contemporary management. Editor John A. Libertino. Springer New York, 2013

Postoperative complications


Кровотечение

Отсроченное кровотечение — наиболее распространенное осложнение, требующееся вторичного вмешательства после LPN. В зависимости от тяжести послеоперационное кровотечение устраняется комбинацией переливания крови, селективной ангиоэмболизации или повторным вмешательством с локальным контролем против выполнения нефрэктомии.

Просачивание мочи

A urine leak is a result of collecting system entry with tumor resection. Depth and size of the lesion is associated with collecting system entry, but this does not necessarily translate to increased likelihood of postoperative urinary leak. Typically, a drain is left in place in the operating room, which can aid in diagnosis and treatment of urinary leakage. The clinical presentation may include rising serum creatinine, increasing drain output, ileus, or worsening flank pain. Diagnosis is confirmed by an elevated drain fluid creatinine. Most cases of urinary leakage are treated conservatively with ureteral stent, percutaneous drain, and bladder drainage. Antibiotics should be initiated in the patient who is febrile or has a leukocytosis. If the urine leak does not heal with these measures, the patient may need a percutaneous nephrostomy tube for complete urinary diversion and extremely rarely a second surgical procedure to close the defect.

 

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