Prognostic value of intraoperative measurements of renal tissue oxygenation and microcirculation on renal function in partial nephrectomy

Maruschke, Matthias; Hagel, Katja; Hakenberg, Oliver W.; Scheeren, Thomas

doi:10.1007/s10157-017-1506-6

Cited by 1 publication

(1 citation statement)

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“…Zero/selective vascular clamping may help to preserve normal parenchyma and therefore provides potential benefits for functional outcomes in comparison to cold ischemia 13 . Matthias et al showed that the off-clamping technique statistically marginally tended to maintain better microcirculation during partial nephrectomy than on-clamping 31 .…”

Section: Discussionmentioning

confidence: 99%

Changes in kidney function according to ischemia type during partial nephrectomy for T1a kidney cancer

Lee

Hwang

Yoo

et al. 2022

Sci Rep

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To compare the postoperative estimated-glomerular-filtration-rate (eGFR) and parenchymal changes between cold ischemia and zero/selective ischemia for a T1a mass. We analyzed 104 patients who underwent open partial nephrectomy with cold ischemia (53) or zero/selective ischemia (51) for T1a between 2008 and 2018 to determine postoperative renal function changes and associated factors. Postoperative renal function was expressed as (postoperative-eGFR − preoperative-eGFR)/preoperative-eGFR × 100%. Parenchymal enhancement and thicknesses of the ipsilateral kidney as tissue changes were measured on postoperative CT to identify the correlation with the renal function change. Patients with 10% or 25% decrease in eGFR were significantly more in the cold ischemia group (p = 0.032, p = 0.006). On multivariable analysis, preoperative eGFR, ischemic type, and percent change of parenchymal thickness were identified to be significantly associated with postoperative 12 months renal function (B = − 0.367, p = 0.020; B = 6.788, p = 0.042; B = 0.797, p = 0.029). Change in parenchymal thickness was negatively correlated with changes in postoperative renal function (r = − 0.277, p = 0.012). Changes in eGFR were associated with a decrease in parenchymal thickness and the type of ischemic technique. Zero/selective ischemia during partial nephrectomy may have an advantage in preserving postoperative renal function compared to cold ischemia.

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Section: Discussionmentioning

confidence: 99%