Evaluation of Surgical Decompression of Polycystic Kidneys by Differential Renal Clearances

Milam, John; Magee, Joseph H.; Bunts, R. Carl

doi:10.1016/s0022-5347(17)64378-7

Cited by 19 publications

(7 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There were also studies[ 7 – 9 ] shown that decortication might not prolong the augmentation of renal cysts with respect to the beginning and the development mechanisms of the cyst. In contrast, after the perirenal fascia was cut, the large renal cysts were decorticated, and the visualized cysts were depressurized; thus, countless microcysts might lose their original constraints and be exposed to a looser growing space.…”

Section: Discussionmentioning

confidence: 99%

Which Stage of ADPKD Is More Appropriate for Decortication? A Retrospective Study of 137 Patients from a Single Clinic

Qian

Sheng

et al. 2015

PLoS ONE

View full text Add to dashboard Cite

ObjectiveTo study retrospectively the efficacy of decortication in patients with different stages of ADPKD and to determine which stage for decortication is more appropriate.Materials and MethodsWe analyzed 137 patients with ADPKD from 2001 to 2010. All patients were divided into three stages. A total of 70 patients underwent decortication, and we studied intraoperative indicators and postoperative indicators at 1 and 3 years follow-up.ResultsIn 70 patients who underwent decortication, significant differences were observed in operative duration and bleeding volume between patients with stage I and II ADPKD (P<0.05), but no significant differences were observed in intestinal recovery time, pain medication dose, and the days of postoperative hospitalization (P > 0.05). The total complication occurrence rate was significantly different between them (P < 0.05). The serum creatinine (Scr) levels in patients with stage I ADPKD were within normal limits 1 and 3 years postoperatively and did not differ significantly (P > 0.05). Scr levels were significantly decreased in patients with stage II ADPKD in the 1st postoperative year (P < 0.05), but these were not significant differences in the 3rd postoperative year (P > 0.05). In the 1st postoperative year, VAS value, blood pressure and renal volume significantly differed (P < 0.05). However, no significant differences were observed 3 years later (P > 0.05).ConclusionsDecortication in patients with stage I ADPKD can alleviate back pain symptoms and decrease blood pressure within 1 year, but the long-term efficacy is not ideal. Scr levels can be maintained within normal limits, suggesting that decortication does not lead to deterioration of renal function. For patients with stage II ADPKD, decortication can significantly improve renal function over the short term. However, after 3 years, renal function returns to the preoperative level, and surgical difficulties and complications also increase.

show abstract

Section: Discussionmentioning

confidence: 99%

Which Stage of ADPKD Is More Appropriate for Decortication? A Retrospective Study of 137 Patients from a Single Clinic

Qian

Sheng

et al. 2015

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…This conclusion was based on a comparison of the preoperative and postoperative creatinine clearance (CrCl) of two CD patients with those of two nonsurgical controls after 13 months of follow-up. The next publication-by Milam and associates 13 in 1963-stated that CD did not improve renal function in their two patients, as measured by inulin and paraaminohippuric acid clearance. They postulated, however, that renal function before surgery may well be an important factor in determining postoperative function.…”

Section: Renal Functionmentioning

confidence: 96%

“…Although surgical CD has been reported since the early 19th century, the laparoscopic approach in patients with ADPKD was initially described in 1995 by Teichman and Hulbert 12 in a case report of six patients with ADPKD, all of whom had failed to achieve pain relief by percutaneous cyst aspiration. [8][9][10]13,14 At the time of their study, LCD had already been used in managing simple renal cysts. At present, LCD, in resemblance to open CD, aims at maximizing the number of cysts treated.…”

Section: Surgical Techniquementioning

confidence: 99%

“…The clinically relevant observation that can be drawn either by direct report or through extrapolation of the data published is that renal function appears to suffer the greatest impairment after surgery if there is poor baseline renal function before surgery. 10,11,13,18,24,26 Whether LCD itself alters the natural course of progression to ESRD in patients with compromised preoperative renal function remains an open question. Elzinga and colleagues 24 attempted to answer this question by comparing the slope of reciprocal serum creatinine plots preoperatively and at postoperative follow-up in patients with renal insufficiency (serum creatinine > 1.4 mg/ dL).…”

Section: Surgery and Adpkdmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Cyst Decortication in Autosomal Dominant Polycystic Kidney Disease

Millar

Tanagho²,

Haseebuddin³

et al. 2013

Journal of Endourology

View full text Add to dashboard Cite

Despite a potential role in blood pressure management in the setting of ADPKD, surgical cyst decortication has not been definitively shown to alleviate hypertension in this clinical setting. Renal function does not appear to improve following this surgery. Patients with compromised baseline renal function appear to be at increased risk for further deterioration in renal function after cyst decortication, although the role of this procedure in altering the natural trajectory of renal failure in this patient subset needs further investigation. Cyst decortication is highly effective in the management of disease-related chronic pain for the majority of patients with ADPKD, providing durable pain relief in this patient population.

show abstract

“…Other authors deny the harmful effect of cysts on the renal parenchyma by compression because they did not found histological injuries confirming it [2], The re duction of the cyst volume by Rovsing's operation was performed frequently in the past until the 1960s. This method was abandoned because worsening of the renal function was shown in a little number of cases [3]. In the last years, several authors have reported the absence of deleterious effects in the kidneys by reduction of the cyst volume with improvement in renal function [4] and de creases in lumbar pain and arterial hypertension.…”

mentioning

confidence: 99%

Effect of Reduction of Cystic Volume by Percutaneous Cystic Puncture on the Renal Function in Polycystic Kidney Disease

García¹,

Brú²,

Campistol³

et al. 1990

Nephron

View full text Add to dashboard Cite

Evaluation of Surgical Decompression of Polycystic Kidneys by Differential Renal Clearances

Cited by 19 publications

References 16 publications

Which Stage of ADPKD Is More Appropriate for Decortication? A Retrospective Study of 137 Patients from a Single Clinic

Which Stage of ADPKD Is More Appropriate for Decortication? A Retrospective Study of 137 Patients from a Single Clinic

Surgical Cyst Decortication in Autosomal Dominant Polycystic Kidney Disease

Effect of Reduction of Cystic Volume by Percutaneous Cystic Puncture on the Renal Function in Polycystic Kidney Disease

Contact Info

Product

Resources

About