To clamp or not to clamp? Long-term functional outcomes for elective off-clamp laparoscopic partial nephrectomy

BJU International
Paras H ShahLouis R Kavoussi

Abstract

To evaluate whether elective off-clamp laparoscopic partial nephrectomy (LPN) affords long-term renal functional benefit compared with the on-clamp approach. This is a retrospective review of patients who underwent elective LPN between 2006 and 2011. Patients were followed longitudinally for up to 5 years. In all, 315 patients with radiographic evidence of a solitary renal mass and normal-appearing contralateral kidney underwent elective LPN; 209 were performed on-clamp vs 106 off-clamp. One patient who required conversion from LPN to open PN was excluded from the study. Additionally, four patients in the on-clamp cohort who underwent subsequent radical nephrectomy for local-regional recurrence were excluded from longitudinal functional evaluation after their procedure. The primary objective was to evaluate differences in postoperative estimated glomerular filtration rate (eGFR) between hilar clamping groups. Subgroup analyses were performed for patients with clamp times >30 min and those with baseline renal insufficiency (eGFR <60 mL/min/1.73m(2) ). Risk of developing worsened or new-onset renal insufficiency was also compared. The mean preoperative eGFR was similar between the on-clamp and off-clamp cohorts (80.7 vs 84.1 mL/m...Continue Reading

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Citations

Feb 26, 2016·Abdominal Radiology·Nirav PatelDavid J Breen
Jun 18, 2016·Current Urology Reports·Hamed Ahmadi, Jen-Jane Liu
Jan 25, 2017·BJU International·Veronica MacchiVincenzo Ficarra
Aug 28, 2016·Technology in Cancer Research & Treatment·Lasse L NonboeMichael Borre
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Oct 14, 2020·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Leonardo Oliveira Reis, Cristiano Trindade Andrade
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