You have accessJournal of UrologyKidney Cancer: Basic Research1 Apr 2011385 WARM ISCHEMIA REDUCES THE NUMBER OF NEPHRONS IN A PIG MODEL Diogo de Souza, Letícia Oliveira, Márcia Cruz, Edmundo Abílio, Waldemar Costa, Marco Aurélio Pereira-Sampaio, and Francisco Sampaio Diogo de SouzaDiogo de Souza Rio de Janeiro, Brazil More articles by this author , Letícia OliveiraLetícia Oliveira Alegre, Brazil More articles by this author , Márcia CruzMárcia Cruz Campos, Brazil More articles by this author , Edmundo AbílioEdmundo Abílio Campos, Brazil More articles by this author , Waldemar CostaWaldemar Costa Rio de Janeiro, Brazil More articles by this author , Marco Aurélio Pereira-SampaioMarco Aurélio Pereira-Sampaio Niterói, Brazil More articles by this author , and Francisco SampaioFrancisco Sampaio Rio de Janeiro, Brazil More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.473AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic partial nephrectomy has been widely used as a nephron sparing surgery for treatment of small renal tumors. Recently, warm ischemia has regaining attention and is now considered the most important negative aspect related to this surgery. Methods for kidney preservation from ischemia are being studied with functional tests, such as serum creatinine and glomerular filtration rate. The aim of this work was to investigate the number of nephrons after warm ischemia, during laparoscopic partial nephrectomy by unbiased stereological methods in a pig model. METHODS Fourteen animals suffered left partial laparoscopic nephrectomy caudal or cranial pole. Renal vessels were clamped and 25% of kidney length was resected. Surgical and ischemia times were recorded. Animals were euthanized after two weeks and kidneys were fixed in formaldehyde. Other four animals were used as controls. Thus, we analyzed 14 kidneys submitted to warm ischemia (left kidneys), 14 kidneys from the same animals, but not submitted to ischemia (right kidney) and 8 control kidneys. Fragments from these 36 kidneys were processed by routine histological methods. Fragment of the left kidney was collected from the non operated pole. Glomerular mean volume and glomerular density were quantified by stereological methods. ANOVA with Newman-Keuls post-test was used for mean comparisons. Also creatinine serum levels after two weeks of surgery were compared to pre-operative levels by Student t test. RESULTS Surgical time was 71±17 minutes and ischemia time was 16±5 minutes. Glomerular mean volume of left kidneys was higher (p<0.05) in comparison to control and right kidneys (30% and 18%, respectively). Also, glomerular density was reduced in left kidneys (p<0.05) by 41% and 36% when compared to control and right kidneys. No statistic difference between control and right kidneys was found. Despite the 41% nephron reduction, creatinine serum levels after two weeks of surgery were not significantly different from pre-operative levels. All numerical data are present in table 1. Table 1. Stereological data of kidneys from animals submitted to left laparoscopic partial nephrectomy and control animals. Left kidneys were submitted to warm ischemia unlike Right and control kidneys Control (n=8) Right (n=14) Left (n=14) P value Vv[Glom] (%) 4.32±0.65 4.46±0.75 3.34±0.60 0.0003 MGV (103 μm3) 0.93±0.17 1.03±0.24 1.22±0.26 0.0234 Glomerular density (/mm3) 48.37±16.5 44.54±10.1 28.22±7.3 0.0002 Data expressed as mean ± SD. Vv[Glom], glomerular volume density. MGV, mean glomerular volume. CONCLUSIONS Warm ischemia during laparoscopic partial nephrectomy promoted an important reduction of nephrons. Stereological determination of the number of glomerulus can be used as a objective method in studies regarding protection from ischemia. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e156 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Diogo de Souza Rio de Janeiro, Brazil More articles by this author Letícia Oliveira Alegre, Brazil More articles by this author Márcia Cruz Campos, Brazil More articles by this author Edmundo Abílio Campos, Brazil More articles by this author Waldemar Costa Rio de Janeiro, Brazil More articles by this author Marco Aurélio Pereira-Sampaio Niterói, Brazil More articles by this author Francisco Sampaio Rio de Janeiro, Brazil More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...