Department of Radiology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-ku, Tokyo, 141-8625, Japan.
Department of Radiology, Japanese Red Cross Saitama Hospital, 1-5, Shintoshin, Chuoh-ku, Saitama, 330-8553, Japan.
Abdom Radiol (NY). 2017 Jul;42(7):1819-1824. doi: 10.1007/s00261-017-1117-4.
This study aimed to investigate the frequency of fat retention in the bladder using postoperative computed tomography (CT) and the associated imaging or clinical findings in patients who underwent renal tumor surgery.
We retrospectively reviewed postoperative CT images from 123 patients who underwent surgery for renal tumors (92 patients after partial nephrectomy and 31 after total nephrectomy). Furthermore, we evaluated preoperative tumor characteristics per an established standardized nephrometry scoring system (the R.E.N.A.L Nephrometry Score) for patients with partial nephrectomy. We also investigated whether collecting system repair occurred during surgery.
Fat retention in the bladder was found in 5 patients (5.4%) after partial nephrectomy, but was not observed in any patients after total nephrectomy. No fat retention was seen immediately after partial nephrectomy (4-8 days), but occurred 2-15 months after the surgery. Subsequently, intravesical fat retention disappeared in 3 patients (8, 24, and 16 months later), and it persisted from 19-22 months after surgery in the remaining 2 patients. Collecting system repair occurred in 25 patients (27%) with partial nephrectomy. There was no statistically significant association between fat retention in the bladder and intraoperative collecting system repair (p = 0.12). The association with intravesical fat retention was not significant for either tumor size, distance to the collecting system, or the R.E.N.A.L. Nephrometry Score.
Fat retention in the bladder after partial nephrectomy can be observed using CT, although it is relatively rare. It is clinically asymptomatic and disappears spontaneously in most cases.
本研究旨在通过术后计算机断层扫描（CT）观察行肾肿瘤手术患者膀胱脂肪保留的频率，并探讨其相关影像学或临床发现。
我们回顾性分析了 123 例行肾肿瘤手术患者（92 例行部分肾切除术，31 例行根治性肾切除术）的术后 CT 图像。此外，我们还评估了行部分肾切除术患者的术前肿瘤特征，依据既定的标准化肾肿瘤评分系统（R.E.N.A.L. 肾肿瘤评分系统）。我们还研究了手术中是否进行了集合系统修复。
5 例（5.4%）行部分肾切除术患者术后出现膀胱脂肪保留，但无任何行根治性肾切除术患者出现该现象。术后 4-8 天行部分肾切除术时未见膀胱内脂肪保留，但术后 2-15 个月时出现该现象。随后，3 例患者（8、24 和 16 个月后）膀胱内脂肪保留消失，另外 2 例患者的该现象持续 19-22 个月。25 例行部分肾切除术患者中（27%）行集合系统修复。膀胱内脂肪保留与术中集合系统修复之间无统计学显著相关性（p=0.12）。膀胱内脂肪保留与肿瘤大小、距集合系统的距离或 R.E.N.A.L. 肾肿瘤评分均无显著相关性。
CT 可观察到部分肾切除术后膀胱脂肪保留，尽管其相对少见。该现象通常无临床症状，且多数情况下可自发消失。
