Dai J R, Shi M L, Li Y P
Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing.
Zhonghua Zhong Liu Za Zhi. 1994 Mar;16(2):144-7.
CT of the retroperitoneum in 70 patients (98 scans) who had undergone previous nephrectomy for renal cell carcinoma was reviewed. The interval between surgical operation and CT scanning were 15 days-7 years. In 59 cases (84%), CT scans were performed within the first 2 years. After nephrectomy, the emptied renal fossae were filled with adjacent organs, such as colon (27), small intestine (21), liver (14), inferior vena cava (3), adrenal gland (2) on the right side, and spleen (28) small intestine (33), colon (15), tail of pancreas (11), adrenal gland (2) on the left. In 47 cases, where CT scans were done within 4 months after operation, there were abscess/hematoma (8) and soft tissue thickening caused by post-operative edema and or inflammation (6). Most of the early post-operative complications gradually reduced in size in the follow-up scans. Local recurrences or metastases were detected by CT scan in 15 cases, with recurrence at the excision site (5), renal bed (6), adrenal gland (4), retroperitoneal lymph nodes (7) and contralateral kidney (1). 7 patients had solitary lesions and 8 patients had multiple recurrences. In 2 patients, local recurrences were detected by routine follow-up CT scanning. In 4 cases, recurrences were proved by surgery, and the others by clinical follow-up. Local recurrences were assessed within 2 years in 10/15 cases (67%), and 4 cases within 6 months. 9 cases had venous thrombosis (IVC 9, renal vein 3), the size of which was reduced after radiotherapy in 1 case. CT is the most preferred imaging technique in evaluating post-nephrectomy patients for renal cell carcinoma.
回顾性分析了70例（98次扫描）因肾细胞癌接受过肾切除术患者的腹膜后CT影像。手术与CT扫描的间隔时间为15天至7年。其中59例（84%）在术后2年内进行了CT扫描。肾切除术后，空虚的肾窝被邻近器官填充，右侧有结肠（27例）、小肠（21例）、肝脏（14例）、下腔静脉（3例）、肾上腺（2例），左侧有脾脏（28例）、小肠（33例）、结肠（15例）、胰尾（11例）、肾上腺（2例）。47例在术后4个月内进行CT扫描的患者中，发现有脓肿/血肿（8例）以及术后水肿和/或炎症引起的软组织增厚（6例）。大多数术后早期并发症在后续扫描中体积逐渐缩小。CT扫描发现15例局部复发或转移，复发部位包括切除部位（5例）、肾床（6例）、肾上腺（4例）、腹膜后淋巴结（7例）和对侧肾脏（1例）。7例为孤立性病变，8例为多发复发。2例通过常规随访CT扫描发现局部复发。4例经手术证实复发，其余经临床随访证实。15例中有10例（67%）在2年内评估局部复发，4例在6个月内。9例有静脉血栓形成（下腔静脉9例，肾静脉3例），1例放疗后血栓大小缩小。CT是评估肾细胞癌肾切除术后患者的首选影像学检查技术。
