Abstract
To evaluate histological parameters in rat renal tissue after tadalafil use during hot ischemia for 45 minutes and reperfusion for 24 hours. Twenty rats were divided into 2 groups. In the experimental group 10 mg/kg of tadalafil was used per gavage before the procedure. All cases underwent left partial nephrectomy, followed by 45 minutes of warm ischemia. Left nephrectomy of the remaining kidney was performed after 24 hours from the initial procedure. The histological parameters analyzed were: detachment of tubular cells, accumulation of desquamated cells in the proximal tubule, loss of brush border, tubular cylinders, interstitial edema, leukocyte infiltration, capillary congestion, vacuolization, tubular dilatation, necrosis and collapse of the capillary tuft. Two rats from each group died and were excluded from the study. Tadalafil significantly reduced leukocyte infiltration (p = 0.036). The remaining histological parameters did not show statistical difference between the groups. The use of tadalafil during warm ischemia and reperfusion demonstrates statistically significant reduction of leukocyte infiltration in the renal interstitium.
Highlights
Cell injury occurs according to several degrees after procedures that cause interruption of blood flow and temporary ischemia of the kidney
With the advent of laparoscopic partial nephrectomy as a gold standard method for treatment of renal tumors, hypothermia, that was routinely used in open surgeries to increase the period of ischemia, is no longer performed due to technical aspects
A period of 20 to 30 minutes of warm ischemia is considered safe for performing the procedure without repercussion to the functioning of the kidney, which makes the preservation of renal cells challenging in surgery of greater technical difficulty[2]
Summary
Cell injury occurs according to several degrees after procedures that cause interruption of blood flow and temporary ischemia of the kidney. In partial nephrectomies, where the aim of the procedure is the removal of the tumor with the maximum preservation of the renal parenchyma, various degrees of damage to the healthy parenchyma occur, especially in prolonged surgeries. During the partial nephrectomy procedure, it is necessary to interrupt blood flow to the kidney in order to reduce intraoperative bleeding and increase the safety of the procedure, leading to a temporary renal tissue ischemia[1]. With the advent of laparoscopic partial nephrectomy as a gold standard method for treatment of renal tumors, hypothermia, that was routinely used in open surgeries to increase the period of ischemia, is no longer performed due to technical aspects. A period of 20 to 30 minutes of warm ischemia is considered safe for performing the procedure without repercussion to the functioning of the kidney, which makes the preservation of renal cells challenging in surgery of greater technical difficulty[2]
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