Long-Term Functional Outcome of Renal Units after Laparoscopic Nephron-Sparing Surgery under Cold Ischemia

Abukora, Firas; Albqami, Nasser; Nambirajan, Thiagarajan; Ziegerhofer, Johann; Leeb, Karl; Janetschek, Günter

doi:10.1089/end.2006.20.790

Cited by 21 publications

(5 citation statements)

References 12 publications

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“…Different techniques like intraarterial or retrograde perfusion have been developed to establish cold ischemia but lead to a much more complex and difficult setting with no proven benefit for kidney preservation. [20][21][22] Local hyperthermia by ice slush has been reported in small series, but to date, a rapid and user-friendly technique for renal hypothermia remains elusive. 23,24 Thus, these options would be suitable for difficult cases, such as those with a large or an unfavorably located tumor requiring a vascular clamping time exceeding 30 minutes.…”

Section: Temporary Ischemiamentioning

confidence: 99%

Laparoscopic Partial Nephrectomy Using FloSeal for Hemostasis: Technique and Experiences in 102 Patients

et al. 2009

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Section: Temporary Ischemiamentioning

confidence: 99%

Laparoscopic Partial Nephrectomy Using FloSeal for Hemostasis: Technique and Experiences in 102 Patients

et al. 2009

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“…Upper set: Knotless suturing showing perpendicular transmission of force, which allows better compression. Lower set: Conventional suturing with tangential transmission of force which can result in 'cheese cutting' effect and has its own risks [9]. Infusion of a cold solution at 4°C delivered via a ureteral catheter could also be used [10], but the efficacy of this has not been extensively tested.…”

Section: Cold Ischemiamentioning

confidence: 99%

A Review of Methods for Hemostasis and Renorrhaphy After Laparoscopic and Robot-assisted Laparoscopic Partial Nephrectomy

Rajan

Leveillee

2010

Curr Urol Rep

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The techniques for management of small renal masses (SRMs) have evolved over the past several years. Radical nephrectomy can lead to an increased risk of chronic kidney disease, and the emphasis is now shifting to nephron-conserving techniques. Partial nephrectomy is now considered a standard of care for the management of SRMs, and laparoscopic techniques are becoming popular because they are minimally invasive. The kidneys are extremely vascular organs, and renal hemorrhage is a major cause of morbidity after laparoscopic partial nephrectomies. Control of bleeding and management of calyceal injuries can be difficult and make the procedure technically challenging. This review looks at the various modalities that are available to reduce bleeding and reviews some advances in the area of hemostatic maneuvers during laparoscopic partial nephrectomies.

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“…The ideal method to evaluate residual kidney function in the operated kidney is still undefined. While most authors use serum creatinine assay or 99mtechnetium-labeled mercaptoacetyl triglycine (MAG3) renal scintigraphy with split renal function, others, like Abukora et al [59] proposed estimation of parenchymal transit time (PTT) as a good indicator of ischemic injury. Transit time is the time that a tracer remains within the kidney or within a part of the kidney.…”

Section: For Howlong Can the Kidney Tolerate Warm Ischemia?mentioning

confidence: 99%

Importance and Limits of Ischemia in Renal Partial Surgery: Experimental and Clinical Research

Secín

2008

Advances in Urology

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Introduction. The objective is to determine the clinical and experimental evidences of the renal responses to warm and cold ischemia, kidney tolerability, and available practical techniques of protecting the kidney during nephron-sparing surgery. Materials and methods. Review of the English and non-English literature using MEDLINE, MD Consult, and urology textbooks. Results and discussion. There are three main mechanisms of ischemic renal injury, including persistent vasoconstriction with an abnormal endothelial cell compensatory response, tubular obstruction with backflow of urine, and reperfusion injury. Controversy persists on the maximal kidney tolerability to warm ischemia (WI), which can be influenced by surgical technique, patient age, presence of collateral vascularization, indemnity of the arterial bed, and so forth. Conclusions. When WI time is expected to exceed from 20 to 30 minutes, especially in patients whose baseline medical characteristics put them at potentially higher, though unproven, risks of ischemic damage, local renal hypothermia should be used.

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Long-Term Functional Outcome of Renal Units after Laparoscopic Nephron-Sparing Surgery under Cold Ischemia

Abstract: The parenchymal transit time is a good indicator of ischemic damage. Nephron-sparing surgery can lead to damage even if the ischemia time is short and cold ischemia is used. More data are needed on the factors determining such injury.

Cited by 21 publications

References 12 publications

Laparoscopic Partial Nephrectomy Using FloSeal for Hemostasis: Technique and Experiences in 102 Patients

Laparoscopic Partial Nephrectomy Using FloSeal for Hemostasis: Technique and Experiences in 102 Patients

A Review of Methods for Hemostasis and Renorrhaphy After Laparoscopic and Robot-assisted Laparoscopic Partial Nephrectomy

Importance and Limits of Ischemia in Renal Partial Surgery: Experimental and Clinical Research

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