| Does Prolonged Warm Ischemia After Partial Nephrectomy Under Pneumoperitoneum Cause Irreversible Damage to the Affected Kidney? | |
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MedLine Citation:
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PMID: 22245321 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: We determined the effects of warm ischemia time on the recovery of renal function after partial nephrectomy under pneumoperitoneum. MATERIALS AND METHODS: In this prospective study 37 consecutive patients who underwent laparoscopic partial nephrectomy or robot-assisted partial nephrectomy between June 2008 and May 2009 to remove a single cT1 renal tumor were evaluated using (99m)Tc-diethylenetriamine pentaacetic acid renal scintigraphy preoperatively, and at 3 and 12 months postoperatively. RESULTS: The most significant reduction in the glomerular filtration rate of the affected kidney at 3 and 12 months after surgery (p = 0.018, p = 0.036, respectively) was seen for a warm ischemia time cutoff of 28 minutes. The glomerular filtration rate of the affected kidney was consistently and significantly reduced at 3 and 12 months postoperatively (-22.4% to -30.6%, p <0.001) in patients with a warm ischemia time greater than 28 minutes. In contrast, no significant glomerular filtration rate change was seen in patients with a warm ischemia time of 28 minutes or less. In terms of the contributional change of the affected kidney to total renal function, there is a trend toward a recovery after an initial decrease in both groups with a warm ischemia time greater than 28 minutes vs 28 minutes or less. On multivariate analysis warm ischemia time was a strong independent predictor of glomerular filtration rate reduction even 12 months after surgery (β = -1.3; 95% CI -1.8, -0.7; p <0.001). CONCLUSIONS: If the warm ischemia time is greater than 28 minutes during laparoscopic partial nephrectomy or robot-assisted partial nephrectomy, the functional damage to the affected kidney progresses even up to 1 year after surgery. |
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Authors:
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Jae Duck Choi; Jong Wook Park; Seo Yeon Lee; Byong Chang Jeong; Seong Soo Jeon; Hyun Moo Lee; Han Yong Choi; Seong Il Seo |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-13 |
Journal Detail:
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Title: The Journal of urology Volume: - ISSN: 1527-3792 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Urology, Dongguk University Hospital, School of Medicine, Gyungju, Republic of Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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