Ischemic renal damage after nephron-sparing surgery in patients with normal contralateral kidney

European Urology
Yasuhito FunahashiMomokazu Gotoh

Abstract

Although nephron-sparing surgery (NSS) has been reported not to affect total renal function, the functional damage of the operated kidney is masked by the contralateral kidney in elective indications. To determine ischemic renal damage after NSS. From August 2005 to October 2007, 32 consecutive patients with elective indications underwent NSS. The mean tumor diameter was 2.6 cm. Of our patients, the open surgery was performed in 20 patients, and laparoscopic surgery was performed in 12 patients. NSS was performed by hilar clamping with a warm ischemic time of 24.3 min. We analyzed effective renal plasma flow (ERPF) calculated from (99m)Tc-mercaptoacetyltriglycine ((99m)Tc-MAG-3) renal scintigraphy and renal parenchymal volume (RPV) measured from computed tomography (CT) scan. In addition, we analyzed (99m)Tc-MAG-3 uptake regionally in the surgically non-affected parts. (99m)Tc-MAG-3 and CT scans were performed preoperatively and 1 wk and 6 mo postoperatively. One week after NSS, ERPF of the operated kidney decreased by 28.7% (from 158.9 to 113.3 ml/min per 1.73 m(2), p<0.001), and RPV decreased by 12.6% (from 149.8 to 131.0 cm(3), p<0.001). These changes were stable for 6 mo. Regional (99m)Tc-MAG-3 uptake of the operated kidney...Continue Reading

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Citations

May 7, 2010·Surgical Endoscopy·Ofer N GofritYoav Mintz
Jun 11, 2011·Journal of Endourology·Sangchul LeeSeok-Soo Byun
Mar 15, 2013·JSLS : Journal of the Society of Laparoendoscopic Surgeons·Ofer N GofritYoav Mintz
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