Abstract
To evaluate the glomerular loss after arteriovenous or arterial warm ischemia in a swine model. Twenty four pigs were divided into Group Sham (submitted to all surgical steps except the renal ischemia), Group AV (submitted to 30 minutes of warm ischemia by arteriovenous clamping of left kidney vessels), and Group A (submitted to 30 minutes of ischemia by arterial clamping). Right kidneys were used as controls. Weigh, volume, cortical volume, glomerular volumetric density (Vv[Glom]), volume-weighted glomerular volume (VWGV), and the total number of glomeruli were measured for each organ. Group AV showed a 24.5% reduction in its left kidney Vv[Glom] and a 25.4% reduction in the VWGV, when compared to the right kidney. Reductions were also observed when compared to kidneys of sham group. There was a reduction of 19.2% in the total number of glomeruli in AV kidneys. No difference was observed in any parameters analyzed on the left kidneys from group A. Renal warm ischemia of 30 minutes by arterial clamping did not caused significant glomerular damage, but arteriovenous clamping caused significant glomerular loss in a swine model. Clamping only the renal artery should be considered to minimize renal injury after partial nephrectomies.
Highlights
The diagnosis of small renal masses has been rising over the past two decades[1], and partial nephrectomy is being increasingly performed to treat this type of tumor[2]
The animals were divided into three groups with 8 animals in each: Group Sham was submitted to all surgical steps except the renal ischemia; Group AV was submitted to renal warm ischemia by clamping the renal artery and vein; and Group A was submitted to renal ischemia by only renal artery occlusion
Animals of groups AV and A were submitted to 30 minutes of left kidney warm ischemia, while animals of group Sham were maintained under anesthesia for the same period
Summary
The diagnosis of small renal masses has been rising over the past two decades[1], and partial nephrectomy is being increasingly performed to treat this type of tumor[2]. The renal pedicle was clamped en bloc avoiding the removal of the perivascular adipose tissue This would save about 30 minutes of intraoperative time for dissecting the vessels, and cushion the renal vessels from the vascular clamp[8]. A study in rats submitted to 60 minutes of kidney warm ischemia demonstrated that arterial only clamping did not impair the renal parenchyma, different from arteriovenous clamping that decreased the glomerular number[12]. These studies have shown some advantages on clamping only the renal artery, the impact of this technique for preserving glomeruli in swine is not known
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
