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991 ASSESSMENT OF RENAL DAMAGE FOLLOWING WARM ISCHEMIA TIME DURING LPN: RESULTS OF A PROSPECTIVE STUDY

2010; Lippincott Williams & Wilkins; Volume: 183; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2010.02.1960

1527-3792

Francesco Porpiglia, Cristian Fiori, I. Morra, Riccardo Bertolo, Patrizia Angusti, Valerio Podio, Roberto Mario Scarpa,

Kidney Stones and Urolithiasis Treatments

You have accessJournal of UrologyKidney Cancer: Localized II1 Apr 2010991 ASSESSMENT OF RENAL DAMAGE FOLLOWING WARM ISCHEMIA TIME DURING LPN: RESULTS OF A PROSPECTIVE STUDY Francesco Porpiglia, Cristian Fiori, Ivano Morra, Riccardo Bertolo, Patrizia Angusti, Valerio Podio, and Roberto Mario Scarpa Francesco PorpigliaFrancesco Porpiglia More articles by this author , Cristian FioriCristian Fiori More articles by this author , Ivano MorraIvano Morra More articles by this author , Riccardo BertoloRiccardo Bertolo More articles by this author , Patrizia AngustiPatrizia Angusti More articles by this author , Valerio PodioValerio Podio More articles by this author , and Roberto Mario ScarpaRoberto Mario Scarpa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1960AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of this prospective study is to evaluate the renal damage and the impairment of renal function due to warm ischemia time after laparoscopic partial nephrectomy (LPN). METHODS fter Institutional approval, 57 patients were involved in the study which lasted from October 2006 to December 2008. Patients underwent LPN for renal tumour with transperitoneal or retroperitoneal approach, in all cases tumour resection and parenchymal reconstruction were performed after the clamp of renal artery. Patients were divided into three Groups according to WIT: Group A < 20 min; group B > 20 and < 30 min; Group C > 30 min. Daily proteinuria, serum creatinine (CrS), and creatinine clearance (CrCl) were assessed preoperatively, at 5th postoperative day and at 3rd month. Renal scintigraphy was performed before the procedure, at 5th day, at 3rd month and at one year postoperatively to evaluate the percentage of contribution to renal function (%RF) by the injured kidney and to estimate normalized renal plasma flow (ERPF). The data of three groups were compared with a statistical analysis, a p-value < 0.05 was considered statistically significant. For the purpose of this study, we considered only data until post operative 3rd month. RESULTS The groups A, B, and C consisted of 22, 23 and 12 patients respectively. The three groups were comparable about demographic data and baseline CrS, CrCl, daily proteinuria and %RF. Mean WIT was 14.3 in group A; 25.22' in group B and 36.16'in Group C (p 0.05); daily proteinuria was significantly higher in Groups B and C respect to that in Group A (p=0.04); CrCl in Groups A and B (p>0.05) was significantly higher than that in Group C (p=0.01). The contribute to renal function of operated kidney was lower in the group C vs group A and B (p=0.04), whilst no significant difference was recorded between Groups A and B. Statistical analysis through each Group revealed a recover towards pre-operative conditions of %RF in Group A and B whilst in Group C the %RF did not return to baseline conditions, remaining significantly lower (p=0.0001). CONCLUSIONS Our results demonstrate that kidney damage surely occurs during LPN when WIT is over 30 minutes. The Cut off of 20 minutes which is usually proposed by some Authors is not confirmed by our results. Orbassano (Torino), Italy© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e385-e386 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francesco Porpiglia More articles by this author Cristian Fiori More articles by this author Ivano Morra More articles by this author Riccardo Bertolo More articles by this author Patrizia Angusti More articles by this author Valerio Podio More articles by this author Roberto Mario Scarpa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...