The risk of arterivenous fistula formation after the enbloc stapling of the renal hilum during transperitoneal laparoscopic nephrectomies.

In this report we aimed to search the risk of arterivenous fistula formation after the enbloc stapling of the renal hilum during transperitoneal laparoscopic nephrectomies. We conducted a retrospective review of 35 laparoscopic simple or radical nephrectomies or laparoscopic nephroureterectomies performed between April 2009 and December 2010 for benign and malignant conditions by one surgeon.These patients are clinically followed up for developing new onset diastolic hipertension, abdominal murmur, and congestive heart failure which can caused by arterioveous fistula, ranging from 12 to 28 months in the postoperative period. Furthermore, for evaluating arterioveous fistula formation, triphasic upper abdominal computerized tomography was applied to these patients ranging from 6 to 20 months. During laparoscopic nephrectomy all the patients? enbloc pedicul stapling had made by using the 45mm endovascular staplers. There was not statistically significant difference between the sistolic and diastolic tensions that are measured preoperatively and postoperatively(p>0,005). In physical examination abdominal murmur and new onset congestive heart failure had not found in the patients. Only in one patient the opaque substance is found in the inferior vena cava at the arteriel phase during the triphasic upper abdominal computerized tomography without any symptoms. In the light of all the literature and our results, en bloc stapling of the renal hilum is as safe and effective as individual stapling.