RENAL TOLERANCE TO PROLONGED WARM ISCHEMIA TIME IN A LAPAROSCOPIC VERSUS OPEN SURGERY PORCINE MODEL
2004; Lippincott Williams & Wilkins; Volume: 172; Issue: 6 Part 1 Linguagem: Inglês
10.1097/01.ju.0000138158.16968.8d
ISSN1527-3792
AutoresBrett A. Laven, Marcelo A. Orvieto, Marc S. Chuang, Chad R. Ritch, Patrick Murray, Robert C. Harland, Sharon R. Inman, Charles B. Brendler, Arieh L. Shalhav,
Tópico(s)Abdominal Surgery and Complications
ResumoNo AccessJournal of UrologyInvestigative Urology1 Dec 2004RENAL TOLERANCE TO PROLONGED WARM ISCHEMIA TIME IN A LAPAROSCOPIC VERSUS OPEN SURGERY PORCINE MODEL BRETT A. LAVEN, MARCELO A. ORVIETO, MARC S. CHUANG, CHAD R. RITCH, PATRICK MURRAY, ROBERT C. HARLAND, SHARON R. INMAN, CHARLES B. BRENDLER, and ARIEH L. SHALHAV BRETT A. LAVENBRETT A. LAVEN , MARCELO A. ORVIETOMARCELO A. ORVIETO , MARC S. CHUANGMARC S. CHUANG , CHAD R. RITCHCHAD R. RITCH , PATRICK MURRAYPATRICK MURRAY , ROBERT C. HARLANDROBERT C. HARLAND , SHARON R. INMANSHARON R. INMAN , CHARLES B. BRENDLERCHARLES B. BRENDLER , and ARIEH L. SHALHAVARIEH L. SHALHAV View All Author Informationhttps://doi.org/10.1097/01.ju.0000138158.16968.8dAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To our knowledge the effects of renal warm ischemia (WI) during laparoscopic vs open surgery have not been investigated. Decreased renal blood flow during pneumoperitoneum may precondition the kidney to tolerate longer WI time. Traditionally 30 minutes has defined the limit of renal WI time in open surgery. However, recent reports show renal function recovery at WI times of 45 to 120 minutes. We assessed renal function recovery after prolonged WI during laparoscopic vs open surgery in a solitary kidney porcine model. Materials and Methods: A total of 32 female farm pigs underwent right laparoscopic nephrectomy to create a single kidney model. At 12 days later the animals were randomized into open and laparoscopic groups, each with 4 subgroups, namely 30, 60 and 90 minutes of WI, and a 90-minute control. Serum creatinine and the glomerular filtration rate were assessed preoperatively and on postoperative days 1, 3, 8 and 15. Results: There was no statistical difference in renal function between the laparoscopic and open groups. Although the early decrease in renal function (72 hours) was highest in the 60 and 90-minute WI groups, by postoperative day 15 this difference was not statistically significant. Postoperative day 15 glomerular filtration rate and serum creatinine values were not significantly different from baseline in any of the WI groups. Conclusions: We found no difference in renal function recovery when comparing laparoscopic and open WI. Although WI up to 90 minutes resulted in initial renal dysfunction, by 2 weeks postoperatively function normalized. Our results indicate that in a single kidney porcine model the renal unit can fully recover from WI times of up to 90 minutes. References 1 : Determination of warm ischemia time at donor nephrectomy. Transplantation1988; 45: 147. Google Scholar 2 : Aortic clamping during elective operations for infrarenal disease: the influence of clamping time on renal function. J Vasc Surg2002; 36: 13. 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Google Scholar From the Sections of Urology (BAL, MAO, MSC, CRR, CBB, ALS), Nephrology (PM), Transplant Surgery (RCH), University of Chicago Hospitals and Department of Biomedical Sciences, Ohio University (SRI), Chicago, Illinois© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAbassi Z, Shalabi A, Sohotnik R, Nativ O, Awad H, Bishara B, Frajewicki V, Sukhotnik I, Abbasi A and Nativ O (2018) Urinary NGAL and KIM-1: Biomarkers for Assessment of Acute Ischemic Kidney Injury Following Nephron Sparing SurgeryJournal of Urology, VOL. 189, NO. 4, (1559-1566), Online publication date: 1-Apr-2013.Osman Y, Hamed S, Moustafa F, Barakat N, Elhameed M, Mosbah A, Mansour S, Gaballah M and Shaaban A (2018) Is Solitary Kidney Really More Resistant to Ischemia? 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Volume 172Issue 6 Part 1December 2004Page: 2471-2474 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsischemiaswinekidneyrenal transplantationMetricsAuthor Information BRETT A. LAVEN More articles by this author MARCELO A. ORVIETO More articles by this author MARC S. CHUANG More articles by this author CHAD R. RITCH More articles by this author PATRICK MURRAY More articles by this author ROBERT C. HARLAND More articles by this author SHARON R. INMAN More articles by this author CHARLES B. BRENDLER More articles by this author ARIEH L. SHALHAV Financial interest and/or other relationship with Focus Surgery More articles by this author Expand All Advertisement PDF downloadLoading ...
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