Impact of parenchymal loss on renal function after laparoscopic partial nephrectomy under warm ischemia

Fariborz Bagheri, Csaba Pusztai, László Farkas, Panagiotis Kallidonis, István Buzogány, Zsuzsanna Szabó, J. Lantos, Marianna Imre, Nelli Farkas, Árpád Szántó

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: To elucidate the impact of renal parenchymal loss and the ischemic reperfusion injury (RI) on the renal function after laparoscopic partial nephrectomy (LPN) under warm ischemia (WI). Methods: Thirty-five patients with a single polar renal mass ≤4 cm and normal contralateral kidney underwent LPN. Transperitoneal LPN with WI using en bloc hilar occlusion was performed. The total differential renal function (T-DRF) using 99mTc-dimercaptosuccinic acid was evaluated preoperatively and postoperatively over a period of 1 year. A special region of interest (ROI) was selected on the non-tumorous pole of the involved kidney, and was compared with the same ROI in the contralateral kidney. The latter comparison was defined as partial differential renal function (P-DRF). Any postoperative decline in the P-DRF of the operated kidney was attributed to the RI. Subtraction of the P-DRF decline from the T-DRF decline was attributed to the parenchymal loss caused by the resection of the tumor and suturing of the normal parenchyma. Results: The mean WI time was 22 min, and the mean weight of resected specimen was 18 g. The mean postoperative eGFR declined to 87 ml/min/1.73 m2 from its baseline mean value of 97 ml/min/1.73 m2 (p value = 0.075). Mean postoperative T-DRF and P-DRF of the operated kidney declined by 7 and 3 %, respectively. Conclusions: After LPN of small renal mass, decline in renal function is primarily attributed to parenchymal loss caused by tumor resection and suturing of the normal parenchyma rather than the RI.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalWorld Journal of Urology
DOIs
Publication statusAccepted/In press - Mar 1 2016

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Warm Ischemia
Nephrectomy
Kidney
Reperfusion Injury
Technetium Tc 99m Dimercaptosuccinic Acid

Keywords

  • Laparoscopy
  • Parenchymal loss
  • Partial nephrectomy
  • Renal function
  • Warm ischemia

ASJC Scopus subject areas

  • Urology

Cite this

Bagheri, F., Pusztai, C., Farkas, L., Kallidonis, P., Buzogány, I., Szabó, Z., ... Szántó, Á. (Accepted/In press). Impact of parenchymal loss on renal function after laparoscopic partial nephrectomy under warm ischemia. World Journal of Urology, 1-6. https://doi.org/10.1007/s00345-016-1798-2

Impact of parenchymal loss on renal function after laparoscopic partial nephrectomy under warm ischemia. / Bagheri, Fariborz; Pusztai, Csaba; Farkas, László; Kallidonis, Panagiotis; Buzogány, István; Szabó, Zsuzsanna; Lantos, J.; Imre, Marianna; Farkas, Nelli; Szántó, Árpád.

In: World Journal of Urology, 01.03.2016, p. 1-6.

Research output: Contribution to journalArticle

Bagheri, F, Pusztai, C, Farkas, L, Kallidonis, P, Buzogány, I, Szabó, Z, Lantos, J, Imre, M, Farkas, N & Szántó, Á 2016, 'Impact of parenchymal loss on renal function after laparoscopic partial nephrectomy under warm ischemia', World Journal of Urology, pp. 1-6. https://doi.org/10.1007/s00345-016-1798-2
Bagheri, Fariborz ; Pusztai, Csaba ; Farkas, László ; Kallidonis, Panagiotis ; Buzogány, István ; Szabó, Zsuzsanna ; Lantos, J. ; Imre, Marianna ; Farkas, Nelli ; Szántó, Árpád. / Impact of parenchymal loss on renal function after laparoscopic partial nephrectomy under warm ischemia. In: World Journal of Urology. 2016 ; pp. 1-6.
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abstract = "Purpose: To elucidate the impact of renal parenchymal loss and the ischemic reperfusion injury (RI) on the renal function after laparoscopic partial nephrectomy (LPN) under warm ischemia (WI). Methods: Thirty-five patients with a single polar renal mass ≤4 cm and normal contralateral kidney underwent LPN. Transperitoneal LPN with WI using en bloc hilar occlusion was performed. The total differential renal function (T-DRF) using 99mTc-dimercaptosuccinic acid was evaluated preoperatively and postoperatively over a period of 1 year. A special region of interest (ROI) was selected on the non-tumorous pole of the involved kidney, and was compared with the same ROI in the contralateral kidney. The latter comparison was defined as partial differential renal function (P-DRF). Any postoperative decline in the P-DRF of the operated kidney was attributed to the RI. Subtraction of the P-DRF decline from the T-DRF decline was attributed to the parenchymal loss caused by the resection of the tumor and suturing of the normal parenchyma. Results: The mean WI time was 22 min, and the mean weight of resected specimen was 18 g. The mean postoperative eGFR declined to 87 ml/min/1.73 m2 from its baseline mean value of 97 ml/min/1.73 m2 (p value = 0.075). Mean postoperative T-DRF and P-DRF of the operated kidney declined by 7 and 3 {\%}, respectively. Conclusions: After LPN of small renal mass, decline in renal function is primarily attributed to parenchymal loss caused by tumor resection and suturing of the normal parenchyma rather than the RI.",
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AU - Bagheri, Fariborz

AU - Pusztai, Csaba

AU - Farkas, László

AU - Kallidonis, Panagiotis

AU - Buzogány, István

AU - Szabó, Zsuzsanna

AU - Lantos, J.

AU - Imre, Marianna

AU - Farkas, Nelli

AU - Szántó, Árpád

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N2 - Purpose: To elucidate the impact of renal parenchymal loss and the ischemic reperfusion injury (RI) on the renal function after laparoscopic partial nephrectomy (LPN) under warm ischemia (WI). Methods: Thirty-five patients with a single polar renal mass ≤4 cm and normal contralateral kidney underwent LPN. Transperitoneal LPN with WI using en bloc hilar occlusion was performed. The total differential renal function (T-DRF) using 99mTc-dimercaptosuccinic acid was evaluated preoperatively and postoperatively over a period of 1 year. A special region of interest (ROI) was selected on the non-tumorous pole of the involved kidney, and was compared with the same ROI in the contralateral kidney. The latter comparison was defined as partial differential renal function (P-DRF). Any postoperative decline in the P-DRF of the operated kidney was attributed to the RI. Subtraction of the P-DRF decline from the T-DRF decline was attributed to the parenchymal loss caused by the resection of the tumor and suturing of the normal parenchyma. Results: The mean WI time was 22 min, and the mean weight of resected specimen was 18 g. The mean postoperative eGFR declined to 87 ml/min/1.73 m2 from its baseline mean value of 97 ml/min/1.73 m2 (p value = 0.075). Mean postoperative T-DRF and P-DRF of the operated kidney declined by 7 and 3 %, respectively. Conclusions: After LPN of small renal mass, decline in renal function is primarily attributed to parenchymal loss caused by tumor resection and suturing of the normal parenchyma rather than the RI.

AB - Purpose: To elucidate the impact of renal parenchymal loss and the ischemic reperfusion injury (RI) on the renal function after laparoscopic partial nephrectomy (LPN) under warm ischemia (WI). Methods: Thirty-five patients with a single polar renal mass ≤4 cm and normal contralateral kidney underwent LPN. Transperitoneal LPN with WI using en bloc hilar occlusion was performed. The total differential renal function (T-DRF) using 99mTc-dimercaptosuccinic acid was evaluated preoperatively and postoperatively over a period of 1 year. A special region of interest (ROI) was selected on the non-tumorous pole of the involved kidney, and was compared with the same ROI in the contralateral kidney. The latter comparison was defined as partial differential renal function (P-DRF). Any postoperative decline in the P-DRF of the operated kidney was attributed to the RI. Subtraction of the P-DRF decline from the T-DRF decline was attributed to the parenchymal loss caused by the resection of the tumor and suturing of the normal parenchyma. Results: The mean WI time was 22 min, and the mean weight of resected specimen was 18 g. The mean postoperative eGFR declined to 87 ml/min/1.73 m2 from its baseline mean value of 97 ml/min/1.73 m2 (p value = 0.075). Mean postoperative T-DRF and P-DRF of the operated kidney declined by 7 and 3 %, respectively. Conclusions: After LPN of small renal mass, decline in renal function is primarily attributed to parenchymal loss caused by tumor resection and suturing of the normal parenchyma rather than the RI.

KW - Laparoscopy

KW - Parenchymal loss

KW - Partial nephrectomy

KW - Renal function

KW - Warm ischemia

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