Does preoperative enhanced computed tomography show the invasion to surrounding structures in renal cell carcinoma?

Year 2020, Volume: 12 Issue: 3, 192 - 198, 31.12.2020

Burak Köprü , Turgay Ebiloğlu Sinan Akay , Selçuk Sarıkaya , Murat Zor , Engin Kaya , Giray Ergin , İbrahim Yavan Mesut Gürdal

Abstract

Objective: To determine if preoperative enhanced computed tomography (PECT) yields enough information or not about the invasion to adherent structures before operations for renal cell carcinoma. 

Material and Methods: A total of 50 patients who had open radical or partial nephrectomy due to renal mass between January 2015 and March 2018 enrolled in this retrospective study. The radiologist elaborately examined the fat planes, and regularity/irregularity of the border at the liver, vena cava, aorta, spleen, pancreas, iliopsoas muscle and abdominal posterior wall. The urologist who took part in the operations noted the same parameters while operations or extracted them from operational notes. The diagnosis of invasion in the intraoperative setting was based on findings while dissection of a mentioned organ.

Results: There were 16 (32%) female and 34 (68%) males. The mean patient age was 60.14±13.89 (26-88). The affected renal unit was right kidney in 22 (44%) and left kidney in 28 (56%) patients. The mean time lag from PECT and operations was 34.48±12.07 (1-60) days.

Conclusion: For liver, spleen, pancreas, iliopsoas muscle, and abdominal posterior wall, PECT yielded some false-positive results of adherence or irregularity than detected in surgery. For vena cava and aorta, PECT could not detect the adherence or irregularity that was seen in surgery. 

Keywords

Computed tomography, renal cell ca, invasion

Preoperatif gelişmiş bilgisayarlı tomografi, renal hücreli karsinomda çevre dokulara invazyonu gösterir mi?

Abstract

Amaç: Renal hücreli karsinomların cerrahi tedavilerinden önce preoperatif gelişmiş bilgisayarlı tomografinin komşu yapılara invazyonu hakkında yeterli bilgi verip vermediğini belirlemek.

Gereç ve Yöntemler: Ocak 2015 ile mart 2018 tarihleri arasında böbrek kitlesi nedeniyle açık radikal veya parsiyel nefrektomi yapılan toplam 50 hasta bu retrospektif çalışmaya dahil edildi. Radyolog tarafından preoperatif gelişmiş bilgisayarlı tomografi ile karaciğer, vena kava, aort, dalak, pankreas, iliopsoas kası, karın arka duvarındaki yağ düzlemleri ve sınırlarının düzenliliğini veya düzensizliğini özenle inceledi. Ürolog tarafından intraoperatif olarak aynı parametreleri kaydedildi ve intraoperatif bulgular kayıt altına alındı. İntraoperatif ortamda invazyon tanısı, söz konusu organın diseksiyonu sırasında elde edilen bulgulara göre değerlendirildi.

Bulgular: Çalışmada 16 (% 32) kadın ve 34 (% 68) erkek vardı. Ortalama hasta yaşı 60.14 ± 13.89 (26-88) idi. Etkilenen böbrek ünitesi 22 (% 44) hastada sağ böbrek, 28 (% 56) hastada sol böbrek idi. Preoperatif gelişmiş bilgisayarlı tomografi ile operasyon arası ortalama gecikme süresi 34.48 ± 12.07 (1-60) gün olarak tespit edildi.

Sonuç: Karaciğer, dalak, pankreas, iliopsoas kası ve abdominal arka duvar için preoperatif gelişmiş bilgisayarlı tomografinin ameliyatta tespit edilenden daha fazla yanlış pozitif yapışma veya düzensizlik sonuçları vermektedir. Vena kava ve aort için preoperatif gelişmiş bilgisayarlı tomografi cerrahide görülen doku yapışıklıkları veya düzensizliklerini yeterli düzeyde tespit edememiştir.

Keywords

Bilgisayarlı tomografi, renal hücreli karsinoma, invazyon

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