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Evaluation of surgery-related kidney volume loss to predict the outcomes of laparoscopic partial nephrectomy with segmental renal artery clamping

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Abstract

Background

Laparoscopic partial nephrectomy (LPN) with segmental renal artery clamping has become an important method to minimize the warm ischemia of the kidney during the surgery. In the present study, we adopted a new model of calculating surgery-related kidney volume loss (SKVL), which was derived from the imaging technology to predict the outcomes of LPN with segmental renal artery clamping.

Methods

A total of 111 consecutive patients underwent LPN with available pre- and post-operation computed tomography (CT) scanning data were retrospectively analyzed. The SKVL was calculated using the parameter derived from the CT scan. The correlation between the SKVL and the perioperative outcomes as well as the renal function loss was estimated by the logistic regression analyses.

Results

The mean SKVL was 8.99 cm3; kidney volume and tumor volume was 147.48 cm3 and 25.87 cm3, respectively. The SKVL was associated with maximum diameter of tumor (P = 0.001), tumor volume (P < 0.001), intraoperative blood loss (P < 0.001), and the warm ischemia time (P = 0.004), but not associated with the surgery time (P = 0.322) and complications (P = 0.638). Besides, the SKVL was associated with the renal function loss after LPN (P < 0.001). The multivariable logistic regression showed that SKVL was an independent parameter to predict the renal function loss.

Conclusions

SKVL is a pre-operation parameter derived from the imaging data, which may be used to predict the perioperative outcomes and renal function loss of patients undergoing LPN.

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Abbreviations

LPN:

Laparoscopic partial nephrectomy

SKVL:

Surgery-related kidney volume loss

CT:

Computed tomography

MRI:

Magnetic resonance imaging

WI:

Warm ischemia

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Acknowledgements

The authors would like to thank the patients for allowing us to publish this study.

Funding

This research was supported by Key Research and Development Project of Jiangsu Province (BE2018749).

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Author notes

  1. Jie Jiang, Jian Qian and Qian Zhang have contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China

    Jie Jiang, Jian Qian, Qian Zhang, Shaobo Zhang, Pu Li, Chao Qin, Jie Li & Qiang Cao

  2. Division of Urology and Kidney Transplantation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China

    Pengfei Shao

Authors
  1. Jie Jiang
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  2. Jian Qian
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  3. Qian Zhang
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  4. Shaobo Zhang
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  5. Pu Li
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  6. Chao Qin
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  7. Jie Li
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  8. Qiang Cao
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  9. Pengfei Shao
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Contributions

JJ, JQ, and QZ drafted the manuscript and collected important patient’s information. SZ, PL, CQ, and JL analyzed and interpreted the patient data. QC and PS reviewed the manuscript. All authors have read and approved the final manuscript.

Corresponding authors

Correspondence to Qiang Cao or Pengfei Shao.

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Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

This study was approved by Ethics Committee of the First Affiliated Hospital, Nanjing Medical University, Jiangsu Province Hospital.

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Written informed consent was obtained from the patients for publication.

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Jiang, J., Qian, J., Zhang, Q. et al. Evaluation of surgery-related kidney volume loss to predict the outcomes of laparoscopic partial nephrectomy with segmental renal artery clamping. Int Urol Nephrol 52, 35–40 (2020). https://doi.org/10.1007/s11255-019-02293-0

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  • DOI: https://doi.org/10.1007/s11255-019-02293-0

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