You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy II (PD11)1 Apr 2020PD11-12 INVESTIGATING A NOVEL MODIFIABLE FACTOR AFFECTING RENAL FUNCTION AFTER PARTIAL NEPHRECTOMY: CORTICAL RENORRHAPHY Anna Fenner*, Chandru Sundaram, and Clinton Bahler Anna Fenner*Anna Fenner* More articles by this author , Chandru SundaramChandru Sundaram More articles by this author , and Clinton BahlerClinton Bahler More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000845.012AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renorrhaphy of the cortical/superficial layer is routinely performed during partial nephrectomy, but the contribution to renal volume loss is not well studied. Cortical renorrhaphy is hypothesized to be a modifiable factor affecting renal function after partial nephrectomy. METHODS: A randomized, controlled trial was conducted with 1:1 allocation between cortical renorrhaphy and no cortical renorrhaphy during robotic partial nephrectomy. Sutures for hemostasis and collecting system closure were placed in all cases. Power analysis recommended a sample size of n=20 per group. An interim analysis was performed at 5 years due to slow accrual. Three-dimensional renal models were constructed using semi-automatic segmentation and planimetry prior to surgery and at approximately 4-months after tumor resection to determine volume loss in the operated kidney. Welch’s t-test was used with statistical significance defined as p<0.05. RESULTS: At interim analysis, 10 were randomized to the non-renorrhaphy group and 8 to the cortical renorrhaphy group. Tumor diameter (3.2 vs. 3.1cm, p=0.67) and warm ischemia time (18 vs. 17 minutes, p=0.63) were similar between the groups. The two groups had matched demographics including age (p=0.82), sex (p=1), BMI (p=0.40), RENAL nephrometry score (p=0.69), diabetic status (p=0.28), and hypertension status (p=0.67). The median (range) volume loss in the non-renorrhaphy group, 12% (0-24%), was lower than the cortical renorrhaphy group, 22% (12-39%), p=0.03. At the one-month mark, the % creatinine change was higher in the renorrhaphy group (7.5% vs -4.4%, p=0.049). There was one Clavien 3 complication in each group: the renorrhaphy group had one urine leak requiring a drain, and the non-renorrhaphy group had one postoperative bleed requiring selective embolization. CONCLUSIONS: This small randomized trial found increased creatinine and volume loss in the cortical renorrhaphy group. Omitting cortical renorrhaphy may result in better preservation of kidney volume and function. Source of Funding: This research was supported by Indiana University Health, Indiana as an awarded Values Fund Research proposal. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e258-e258 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anna Fenner* More articles by this author Chandru Sundaram More articles by this author Clinton Bahler More articles by this author Expand All Advertisement PDF downloadLoading ...