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Long-Term Functional Evaluation of the Treated Kidney in a Prospective Series of Patients Who Underwent Laparoscopic Partial Nephrectomy for Small Renal Tumors

Porpiglia, Francesco ; Fiori, Cristian ; Bertolo, Riccardo ; Morra, Ivano ; Russo, Roberto ; Piccoli, Giorgina ; Angusti, Tiziana ; Podio, Valerio

European urology, 2012-07, Vol.62 (1), p.130-135 [Periódico revisado por pares]

Switzerland: Elsevier B.V

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Título:
Long-Term Functional Evaluation of the Treated Kidney in a Prospective Series of Patients Who Underwent Laparoscopic Partial Nephrectomy for Small Renal Tumors
Autor: Porpiglia, Francesco ; Fiori, Cristian ; Bertolo, Riccardo ; Morra, Ivano ; Russo, Roberto ; Piccoli, Giorgina ; Angusti, Tiziana ; Podio, Valerio
Assuntos: Adult ; Aged ; Carcinoma, Renal Cell - blood supply ; Carcinoma, Renal Cell - diagnostic imaging ; Carcinoma, Renal Cell - surgery ; Creatinine - blood ; Female ; Glomerular Filtration Rate - physiology ; Humans ; Kidney Neoplasms - blood supply ; Kidney Neoplasms - diagnostic imaging ; Kidney Neoplasms - surgery ; Laparoscopy ; Laparoscopy - methods ; Male ; Middle Aged ; Nephrectomy - methods ; Partial nephrectomy ; Prospective Studies ; Radionuclide Imaging ; Renal ischemia ; Renal scintigraphy ; Technetium Tc 99m Mertiatide ; Treatment Outcome ; Urology ; Warm Ischemia - adverse effects
É parte de: European urology, 2012-07, Vol.62 (1), p.130-135
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
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Descrição: Abstract Background Renal scintigraphy may allow long-term monitoring of ischemic damage after partial nephrectomy (PN). Objective Evaluate use of renal scintigraphy for evaluating long-term effects of warm ischemia on renal function in patients with a normal contralateral kidney. Design, setting, and participants We prospectively examined kidney function of 54 patients who underwent laparoscopic PN (LPN). Minimum follow-up time was 4 yr. Intervention LPN was performed with warm ischemia by transperitoneal or retroperitoneal approach. Measurements Demographic, perioperative, and pathologic data and postoperative complications were registered. Split renal function (SRF) and effective renal plasma flow (ERPF) were evaluated by renal scintigraphy preoperatively, at 3 and 12 mo postoperatively, then yearly. Baseline weighted differentials (b-WDs) of both SRF and ERPF in the affected kidney were calculated between baseline condition and every time point. Multivariate linear regression was used to find independent variables for increased b-WDs at 3 and 48 mo. P values <0.05 were considered significant. Results and limitations The SRF and ERPF of kidneys treated by LPN decreased significantly at month 3 and subsequently remained stable through the duration of follow-up. Conversely, neither serum creatinine nor estimated glomerular filtration rate changed significantly during follow-up. The regression model showed statistical significance at month 3 for warm ischemia time (WIT) and age, whereas at 48 mo, statistical significance was reached by WIT alone. No new onset of cardiovascular disease was registered. No evidence of local recurrence was recorded with computed tomography scan. Our study may be underpowered due to small sample size; however, this is one of the largest long-term prospective series using renal scintigraphy to evaluate the renal function after LPN. Conclusions WIT contributes to irreversible kidney damage observed at month 3 that does not appear to worsen.
Editor: Switzerland: Elsevier B.V
Idioma: Inglês

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Long-Term Functional Evaluation of the Treated Kidney in a Prospective Series of Patients Who Underwent Laparoscopic Partial Nephrectomy for Small Renal Tumors

Porpiglia, Francesco ; Fiori, Cristian ; Bertolo, Riccardo ; Morra, Ivano ; Russo, Roberto ; Piccoli, Giorgina ; Angusti, Tiziana ; Podio, Valerio

Switzerland: Elsevier B.V

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