Preservation of Split Renal Function After Laparoscopic and Robot-assisted Partial Nephrectomy.

Abstract

BACKGROUND/AIM:

To analyze the effects of laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) for the treatment of renal cell carcinoma (RCC) on subsequent split renal function using renal scintigraphy.

PATIENTS AND METHODS:

We retrospectively analyzed data from 174 patients who underwent LPN or RAPN by a single surgeon, and assessed their total and split renal function before and 6 months after each procedure. Split renal function was analyzed using 99mTc-2,3 dimercaptosuccinic acid renal imaging and calculated as the total estimated glomerular filtration rate (eGFR) × uptake ratio on the surgical side/uptake ratio on the contralateral side.

RESULTS:

LPN or RAPN were performed in 51 (29.3%) and 123 (70.7%) participants, respectively. Their median eGFRs before and after surgery were 32.76 and 27.74 ml/min/1.73 m2, respectively, and 70 of them (40.2%) showed a preservation of split eGFR of >90%, which was used to define a successful procedure. Participants who underwent a successful procedure had significantly lower RENAL nephrometry scoring system (RNS) scores and fewer of them had external tumors. Successful procedures were associated with shorter warm ischemia time, were more likely to be RAPN, and less likely to involve parenchymal suturing. Multivariate analysis showed that a low RNS score and parenchymal suturing were significant independent predictors of split renal function following partial nephrectomy (PN).

CONCLUSION:

Preoperative RNS score and the use of parenchymal suturing are significantly associated with a preservation of split renal function of >90% in patients who undergo PN for the treatment of RCC.

• Authors: Kojiro Ohba, Tomohiro Matsuo, Kensuke Mitsunari, Yuichiro Nakamura, Hiromi Nakanishi, Yasushi Mochizuki, Yasuyoshi Miyata
• Journal: Anticancer research (Anticancer Res) Vol. 42 Issue 6 Pg. 3055-3060 (Jun 2022) ISSN: 1791-7530 [Electronic] Greece
• PMID: 35641274 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Topics

• Carcinoma, Renal Cell (etiology, surgery)
• Humans
• Kidney (pathology, physiology, surgery)
• Kidney Neoplasms (pathology)
• Laparoscopy (adverse effects, methods)
• Nephrectomy (adverse effects, methods)
• Retrospective Studies
• Robotics
• Treatment Outcome