Abstract
The data in the literature are confusing and conflicted as to the role of various surgical maneuvers and their impact on postoperative renal function. The aim of this chapter is to review the current literature and to present my own personal experience, regarding the role of warm ischemia and the volume of renal parenchyma preserved on the ultimate postoperative renal functional outcome following partial nephrectomy (PN).
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References
National Kidney Foundation. The facts about chronic kidney disease (CKD). 2018. Available at https://www.kidney.org/kidneydisease/CKD/index.cfm.
Huang WC, Levey AS, Serio AM, et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumors: a retrospective cohort study. Lancet Oncol. 2006;7(9):735–40.
Lane BR, Fergany AF, Wright CJ, et al. Renal functional outcome after partial nephrectomy with extended ischemia intervals are better than after radical nephrectomy. J Urol. 2010;184(4):1286–90.
Go AS, Cherow GM, Fan D, et al. Chronic kidney disease and the risk of death, cardiovascular events and hospitalization. N Engl J Med. 2004;351(13):1296–305.
Bijol V, Mendez GP, Hurwitz S, et al. Evaluation of non-neoplastic pathology in tumor nephrectomy specimens: predicting the risk of progressive renal failure. Am J Surg Pathol. 2006;30(5):575–84.
Seer Incidence Data Base, NIH National Cancer Institute, Surveillance, Epidemiology and End Results Program 1973-2016.
Takagi T, Kondo T, Sizuka J, et al. Postoperative renal function after partial nephrectomy for renal cell cancer in patients with preexisting chronic kidney disease: a comparison with radical nephrectomy. Int J Urol. 2011;18:472–6.
Schumer M, Colomber M, Sawczuk I, Gobe G, Connor J, O’Toole K, Olsson C, Wise G, Buttyan R. Morphologic, biochemical, and molecular evidence of apoptosis during the reperfusion phase after brief periods of renal ischemia. Am J Pathol. 1992;140(4):831–8.
Triaca V, Zagha R, Libertino JA. Does thrombin sealant allow nephron sparing surgery (NSS) without renal artery occlusion? Description of technique and initial results. J Urol. 2005;171(4):Supplement Abstract #1338.
Smith G, Cohen M, Kurteva T, Libertino JA. Non-clamped, non ischemia partial nephrectomy in patients with compromised preoperative renal function or with a solitary kidney. J Urol. 2008;179(4):Supplement Abstract #1096.
Kurteva T, Cohen M, Smith G, Libertino JA. Non-clamped, non-ischemic partial nephrectomy: the new gold standard. J Urol. 2008;179(4):Supplement Abstract #1392.
Smith G, Kenney P, Lee Y, Libertino JA. Non-clamped partial nephrectomy: techniques and surgical outcomes. BJU Int. 2011;107(7):1054–8. https://doi.org/10.1111/j.1464-410X.2010.09798.x. Epub 2010 Oct 29.
Wszolek M, Kenney P, Lee Y, Libertino JA. Comparison of hilar clamping and non-hilar clamping partial nephrectomy for tumors involving a solitary kidney. BJU Int. 2011;107(12):1886–92. https://doi.org/10.1111/j.1464-410X.2010.09713.x. Epub 2010 Nov 11.
Thompson RH, Lane BR, Lohse C, et al. Every minute counts when the renal hilum is clamped during partial nephrectomy. Eur Urol. 2010;58:340–5.
Mukkamalla A, Weier A, Hafez KS, et al. Long-term renal functional outcomes of minimally invasive partial nephrectomy for renal cell cancer. Urol Oncol. 2014;32(8):1247–51.
Rosen D, Oaulucci D, Reynolds C, Abaza R, Eun D, Bahndari A, Hemal A, Badani K, Valet LP. AUA 2018 meeting PD 16-02 reevaluating warm ischemia as a predictor of renal function outcomes in patients undergoing robotic partial nephrectomy.
Simmons MN, Fergany AF, Campbell SC. The effect of parenchymal volume preservation on kidney function after partial nephrectomy. J Urol. 2011;186(2):405–10. Published on line.
Bahler C, Sudaram C, Kondo T. Volume loss after partial nephrectomy-could suture renorrhaphy be a cause? AUA meeting, Boston, Best Poster Prize. 2017.
Bahler CD, Dube HT, Flynn KJ, et al. Feasibility of omitting cortical renorrhaphy during robot assisted partial nephrectomy: a matched analysis. J Endourol. 2015;29:548.
Shuch B, Singer E, Bratslavsky G. The surgical approach to multifoca; renal cancers: ipsilateral multifocality and bilateral tumors. Urol Clin North Am. 2012;39(2):133–48.
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Libertino, J.A., Hamburger, R. (2020). The Surgical Approaches to Renal Masses and Their Impact on Postoperative Renal Function. In: Libertino, J., Gee, J. (eds) Renal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-24378-4_12
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DOI: https://doi.org/10.1007/978-3-030-24378-4_12
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