Abstract
We hypothesized that the left renal vein pressure difference (ΔP) before and after the ligation can serve as an objective indicator for free of reconstruction after resection of a retroperitoneal tumor with renal segment of inferior vena cava and right kidney. After established a model of left renal vein compression, 45 miniature pigs were operated on experimental procedures including renal segment of inferior vena cava resection, right nephrectomy, and left renal vein ligation. The ΔPs of left renal vein before and after the ligation were measured. Safe ΔP variation without causing acute kidney injury was calculated using regression analysis. In human the safety range of ΔP before and after ligation of the left renal vein was calculated by diuretic response test. The safety range of ΔP in animals or human was 0–11.9 or 0–17.5 cm H2O, respectively. The renal function changed dramatically (p < 0.01), characterized by a significant increase in the rate of acute kidney injury when the ΔP was beyond the upper limit of the safety range. In conclusion, ΔP can predict free of reconstruction after resection of a retroperitoneal tumor with the renal segment of the inferior vena cava and the right kidney.
Highlights
We hypothesized that the left renal vein pressure difference (ΔP) before and after the ligation can serve as an objective indicator for free of reconstruction after resection of a retroperitoneal tumor with renal segment of inferior vena cava and right kidney
The renal function represented by clearance rate (CCr) and Δ P before and after operation was evaluated as shown in Table 1.The increased percentage of creatinine was considered as an independent variable, whereas Δ P as the dependent variable
In patients with complex RPTs where the inferior vena cava was invaded but not fully occluded at and above the renal level, we detected the changes in venous pressure before and after the ligation of the left renal vein
Summary
We hypothesized that the left renal vein pressure difference (ΔP) before and after the ligation can serve as an objective indicator for free of reconstruction after resection of a retroperitoneal tumor with renal segment of inferior vena cava and right kidney. There always exists close relationships between the tumor body and important abdominal vasculatures, especially its invasion into the renal level and above the inferior vena cava. This situation very difficult to handle, which requires to rebuild the renal venous return, leading to an increase in the complexity of the operation as well as the incidence of operation-related complications.
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