title: Multidetector CT imaging of complications after laparoscopic nephron-sparing surgery.
abstract: OBJECTIVE
  Laparoscopic nephron-sparing surgery (L-NSS) is increasingly performed to treat localised renal lesions. However, the associated morbidity is non-negligible, with a rate of major complications approaching 10 %.
  
  
  RESULTS
  This paper provides an overview of indications, surgical techniques and results of L-NSS; explains the incidence, risk factors and manifestations of postoperative complications; discusses the preferred multidetector computed tomography (CT) acquisition techniques; illustrates the appearance of normal postoperative images following L-NSS; and reviews, with example images, the most common and unusual iatrogenic complications. These include haematuria, haemorrhage, vascular injuries, infections and urinary leaks. Most emphasis is placed on CT, which provides rapid, reliable triage and follow-up of iatrogenic complications after L-NSS, identifying occurrences that require transarterial embolisation or repeated surgery.
  
  
  CONCLUSIONS
  Multidetector CT allows precise assessment of the surgical resection site; detection of pneumoperitoneum and subcutaneous emphysema; quantification of retroperitoneal blood; and identification of active bleeding, pseudoaneurysms, arterio-venous fistulas, abscess collections and extravasated urine.
  
  
  CONCLUSIONS
  • Laparoscopic nephron-sparing surgery (NSS) is increasingly performed to treat renal lesions. • Radiologists are increasingly requested to investigate suspected post-surgical NSS complications. • Post-NSS complications include haemorrhage, haematuria, vascular injuries, infections and urinary leaks. • Multidetector CT allows choice between conservative treatment, transarterial embolisation or surgery.
authors.affiliation: Department of Radiology, "Luigi Sacco" University Hospital, Via G.B. Grassi 74, 20157, Milan, Italy, mtonolini@sirm.org.
authors.forename: Massimo
authors.initials: M
authors.lastname: Tonolini
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ierardi
authors.forename: Virginia
authors.initials: V
authors.lastname: Varca
authors.forename: Giacomo Piero
authors.initials: GP
authors.lastname: Incarbone
authors.forename: Marina
authors.initials: M
authors.lastname: Petullà
authors.forename: Roberto
authors.initials: R
authors.lastname: Bianco