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Original article: CT appearances following laparoscopic partial nephrectomy for renal cell carcinoma using a rolled cellulose bolster

Abstract

Purpose: To describe the evolving computed tomography (CT) appearances of a cellulose surgical bolster used as a hemostatic agent in patients who undergo laparoscopic partial nephrectomy for renal cell carcinoma. Materials and methods: We retrospectively reviewed the follow-up CT studies of 33 patients with stage T1N0M0 renal carcinoma who underwent laparoscopic partial nephrectomy using a rolled, oxidized, regenerated cellulose sheet sutured in place as a bolster in the parenchymal defect. Thirteen patients undergoing laparoscopic partial nephrectomy without the use of a bolster were also evaluated to differentiate imaging features. Results: The bolster-related masses were significantly larger than those seen in the non-bolster patients. There was a decrease in size of the postoperative bolster-related mass with time. The bolster shape evolved with time, initially appearing oval, and becoming irregular with decreasing size. Equivocal increase in attenuation of 10_20 HU was seen in 6 patients. Increase in attenuation of greater than 20 HU was seen in 3 patients. There was no evidence of tumor recurrence in any of the patients. Invagination of fat was seen in two bolster-related masses at 18 months or greater. Conclusions: Cellulose bolster has a variable appearance on follow-up CT exams. Evolutionary features include reduction in bolster size and shape with time leading finally to non-visualization. Bolster enhancement can mimic abscesses and tumor recurrence.

Author

Deepa Pai, Jonathon M. Willatt, Melvyn Korobkin, Richard H. Cohan, James H. Ellis, Isaac R. Francis, J. Stuart Wolf Jr and Matthew Schipper

Contact Details

Corresponding address:
Jonathon M. Willatt, MBChB, Taubman B-1/132, Box 5302, University of Michigan Hospital, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0030, USA

Reference

ICIS Cancer Imaging Volume 10 Issue 1
DOI: 10.1102/1470-7330.2010.0023

Date Posted

29 July 2010

Open Access is provided for this article.

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