MP75-20 IMPACT OF WARM ISCHEMIA TIME ON RENAL FUNCTIONAL OUTCOME AFTER LAPAROSCOPIC PARTIAL NEPHRECTOMY USING DYNAMIC RENAL SCINTIGRAPHY

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V1 Apr 2016MP75-20 IMPACT OF WARM ISCHEMIA TIME ON RENAL FUNCTIONAL OUTCOME AFTER LAPAROSCOPIC PARTIAL NEPHRECTOMY USING DYNAMIC RENAL SCINTIGRAPHY Tetsuo Fujita, Morihiro Nishi, Daisuke Ishii, Ken-ichi Tabata, Kazumasa Matsumoto, Kazunari Yoshida, and Masatsugu Iwamura Tetsuo FujitaTetsuo Fujita More articles by this author , Morihiro NishiMorihiro Nishi More articles by this author , Daisuke IshiiDaisuke Ishii More articles by this author , Ken-ichi TabataKen-ichi Tabata More articles by this author , Kazumasa MatsumotoKazumasa Matsumoto More articles by this author , Kazunari YoshidaKazunari Yoshida More articles by this author , and Masatsugu IwamuraMasatsugu Iwamura More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1738AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic partial nephrectomy (LPN) is a feasible surgical procedure for selected patients with localized renal tumor whose tumor ≤ 4cm. It has several technical difficulties, such as intracorporeal tumor resection and suturing. Vascular clamping is the best way to facilitate complete tumor resection and precise surgical closure. However, warm ischemia time was identified as the most important factor affecting renal functional outcome after LPN. Renal scintigraphy is the only method to quantify operation side renal function. The present study aimed to explore postoperative operation side renal functional outcome after LPN using dynamic renal scintigraphy. METHODS Between July 2006 and December 2014, 116 consecutive patients with localized renal tumor received ischemic LPN at our institution. Preoperartive, 6 months postoperative, and 12 months postoperative renal function were assessed by dynamic renal scintigraphy using radio-nuclide technetium Tc 99m-mercaptoacetyl-triglycine. Among 116 patients, 88 patients could examine dynamic renal scintigraphy at 6 months postoperatively, and 64 patients could examine at 12 months postoperatively. Postoperative operation side renal function was calculated: postoperative/preoperative split renal function (%). To assess the significant factors affecting postoperative operation side renal functional decrease, simple regression and multivariate regression analyses were carried out. RESULTS Postoperative operation side renal functions were significantly decreased to 87.1% at 6 months and 86.9% at 12 months postoperatively (P < 0.0001, respectively). At 6 months after LPN, simple regression analyses revealed no significant correlation. At 12 months after LPN, simple regression analyses revealed that postoperative operation side renal function was significantly decreased with prolonged warm ischemia time (P = 0.0010). Multivariate regression analysis included age, body mass index, tumor size, R.E.N.A.L. Nephrometry score, operative time, warm ischemia time, estimated blood loss, and specimen weight. At 12 months after LPN, warm ischemia time was identified independent predictive factor for operation side renal functional decrease (P = 0.0062). CONCLUSIONS Prolongation of warm ischemia time of LPN, postoperative operation side renal function was significantly decreased. It was novel finding using split renal function. To avoid the renal functional decrease after LPN, shorter warm ischemia time should be required. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e986 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Tetsuo Fujita More articles by this author Morihiro Nishi More articles by this author Daisuke Ishii More articles by this author Ken-ichi Tabata More articles by this author Kazumasa Matsumoto More articles by this author Kazunari Yoshida More articles by this author Masatsugu Iwamura More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...