Occlusion Of Renal Vessels Research Articles

Partial nephrectomy for renal tumors using selective parenchymal clamping

To describe our experience with partial nephrectomy using selective parenchymal clamping for the treatment of renal tumors. Between 2003 and 2005, seven patients with solid renal tumors underwent partial nephrectomy with selective parenchymal clamping at our Institution. In five, the tumor was in the right kidney and in two the tumor was in the left. Only one patient had a tumor within a solitary kidney. The tumor was located in the upper pole in 2 patients and in the lower pole in 5. Partial nephrectomy was performed with the DeBakey aortic clamp without occlusion of renal vessels. Mean operative time was 236 min (range 175-298 min). Mean intraoperative blood loss was 485 ml with only one patient requiring blood transfusion. There were no major complications. Mean preoperative serum creatinine level was 0.74 mg/dl (range 0.58-1.26 mg/dl) and mean postoperative serum creatinine level was 0.81 mg/dl (range 0.69-1.21 mg/dl) with no patient requiring dialysis. Mean hospital postoperative stay was 5 days (range 4-7 days). Mean tumor size was 2.9 cm (range 1.3-4.0 cm). Pathologic analysis detected renal cell carcinoma in 5 patients, angiomyolipoma in 1 and fibrosis with chronic hemorrhage in 1, all with negative surgical margins. After a mean follow-up of 18 months (range 3-32 months), all patients are free of disease recurrence. Partial nephrectomy with selective parenchymal clamping allows resection of solid masses without damage to normal renal tissue, avoids the risk of renal failure and offers an excellent local cancer control.

Comparison of Radiofrequency Ablation Lesion Size with Occlusion of Renal Vessels in Rabbit Kidneys: Occlusion of Renal Artery, Vein, and Both Vessels

Purpose: The purpose of this study was to compare the in-vivo efficiency of vascular occlusion on radiofrequency ablation (RFA) lesion size in a rabbit kidney model. Materials and Methods: RFA lesions were created in a single kidney in 20 rabbits using an internally cooled electrode. Twenty ablation zones (1 per kidney) were created using 4 different regimens: RFA without vascular occlusion (n = 5), RFA with renal artery occlusion (n = 5), RFA with renal vein occlusion (n = 5), RFA with renal artery and vein occlusion (n = 5). Seven days later, the rabbits were sacrificed and the lesions were excised. These groups were then compared with respect to the dimensions of the ablation zones and the changes in impedance and current during RFA. Results: The maximum ablation zone width was the greatest in the renal artery and vein occlusion group (21.0±1.4 mm), followed by the renal artery occlusion group (17.8±1.0 mm), the renal vein occlusion group (17.4±1.1 mm), and the nonocclusion group (7.8±2.4 mm) (p