Predictive factors for postoperative renal function after off-clamp, non-renorrhaphy partial nephrectomy

Abstract

Background: There is limited information on perioperative renal function during off-clamp, nonrenorrhaphy open partial nephrectomy. Therefore, this retrospective study aimed to identify predictive factors of perioperative decline in renal function after off-clamp, non-renorrhaphy open partial nephrectomy. Methods: Clinical records of 138 patients with renal tumors who underwent off-clamp, non-renorrhaphyopen partial nephrectomy at our institution were reviewed. Off-clamp, non-renorrhaphy partial nephrectomy was performed using a soft coagulation system. Perioperative estimated glomerular filtration rate (eGFR) preservation was calculated, and predictors were identified using multivariate regression analysis at 5 days, 1 month, and 3 months after surgery. Results:The median operation time was 122 minutes, and the median volume of estimated blood loss was 155 mL. The mean eGFR preservation at 5 days, 1 month, and 3 months after surgery was 95.3%, 91.0%, and 90.7%, respectively. Estimated blood loss was an independent predictor of perioperative decline in eGFR

Predictors of renal function deterioration at one year after off-clamp non-renorrhaphy partial nephrectomy

“…In our previous report, we examined perioperative renal function within 3 months after off-clamp, non-renorrhaphy open partial nephrectomy [ 12 ]. Notably, the renal function at 1 year in the current follow-up study remained nearly comparable to that at 3 months after surgery.…”

“…In our previous study, the estimated blood loss served as a predictor for perioperative decline in renal function within the first three months after surgery. We hypothesized that intense use of soft coagulation to control bleeding might damage the renal parenchyma, leading to the loss of renal function [ 12 ]. Over the long term, estimated blood loss remained a predictor of renal function.…”

“…However, parenchymal ischemia and reperfusion resulting from hilar clamping could lead to acute kidney injury through production of radical oxygen species. Omitting both renal hilar clamping and renorrhaphy has been reported as an effective approach for preserving renal function during partial nephrectomy in a relatively short period [2,[12][13][14][15].…”

The effectiveness of off-clamp and non-renorrhaphy technique regarding postoperative renal function in patients with partial nephrectomy

“…In this study, Nakamura et al investigated the perioperative renal function and the utility of off-clamp and non-renorrhaphy technique for preserving renal function after open PN ( 7 ). The authors reviewed the clinical records of 138 patients with renal tumors who underwent open PN using off-clamp and non-renorrhaphy techniques at a single institute between 2013 and 2020.…”