Abstract
Objective To evaluate the effect of selective segmental renal artery clamping (SSRAC) on the liver so as to provide a foundation for the using of SSRAC in partial nephrectomy (PN). Methods A total of 18 domestic pigs were randomized equally into 2 groups according to the method of renal artery clamping such as main renal artery clamping (MRAC) and SSRAC. Each subject underwent radical nephrectomy to right kidney, and then either MRAC or SSRAC was performed to left kidney for 60 minutes. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured before surgery and at 6 time points thereafter (day 1, 7, 14, 21, 28, 90). Liver histology was observed on the first day and the 90th day after operation. Results On the first day after operation, ALT and AST values of the MRAC group were (79.00±9.30) U/L and (264.00±59.85) U/L, which was significantly higher than those of SSRAC group [(52.80±5.81) U/L and (143.20±29.22) U/L, P 0.05). In the MRAC group the liver experienced extensive hydropic degeneration, partial hepatic cells vacuolization and multifocal necrosis on the 1st day, and the above pathological changes were significantly attenuated on the 90th day. However, the liver pathological injury in SSRAC group was less at the two time points. Conclusion Compared with MRAC, SSRAC has a protective effect on liver postoperatively. It's better to choose SSRAC during PN. Key words: Selective renal artery clamping; Main renal artery clamping; Partial nephrectomy; Ischemia-reperfusion injury; Liver injury
Published Version
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