RENAL FUNCTION AFTER LAPAROSCOPIC PARTIAL NEPHRECTOMY WITH SUPERSELECTIVE BALLOON EMBOLIZATION OF RENAL ARTERY


如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Aim. To evaluate the functional state of the renal parenchyma after partial nephrectomy, depending on surgical technique. Materials and methods. The study comprised 21 patients with kidney neoplasms of stage T1-2N0M0. The patients underwent either laparoscopic partial nephrectomy with superselective balloon embolization of the renal artery (study group, n=11), or partial nephrectomy with vascular clamping (control group, n=10). The mean age of the patients in the study group (3 men and 8 women) was 56.8 years. The tumor was located in the right kidney in 5 patients and in the left kidney in 6 patients. The size of the neoplasm ranged from 0.9 to 3.8 cm, averaging 1.9 cm. The complexity of the surgery was evaluated using R.E.N.A.L. Nephrometry Scoring System based on MSCT findings. The mean nephrometry score was 5.1, which corresponds to low complexity of the intervention. Patients of the control group underwent partial nephrectomy with vascular clamping and renal ischemia time of no more than 20 minutes. The mean age of the control group patients was 57.3 years. The tumor was located in the right kidney in 4 patients and in the left kidney in 6 patients. The tumor size ranged from 1 to 4.1 cm, averaging 2.2 cm. The mean nephrometry score based on MSCT findings was 6.1. In both groups, the difference in creatinine clearance between the operated and intact kidney was estimated before the operation and in the early postoperative period to assess the changes in glomerular filtration. Results and discussion. The level of serum creatinine remained within the normal range throughout the study period in both groups. In the postoperative period, the creatinine clearance of the operated kidneys showed 1.02-fold decrease after super selective embolization and 1.92-fold decrease after vascular clamping. The 1-minute diuresis of the operated kidney decreased by 83.21% and 43.53% after vascular clamping and embolization, respectively. Conclusion. The study’s findings show there was no significant dysfunction of operated kidneys after superselective balloon embolization of the renal artery.

全文:

受限制的访问

作者简介

A. Maksimov

Republican Hospital No. 1 of the Republic of Sakha (Yakutia), National Center of Medicine

Email: maximov_alex1971@mail.ru
Head of the Department of Urology Yakutsk, Russia

A. Martov

A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia; PMACPE; D.D. Pletnev CCH, Moscow Health Department

Dr.Med.Sci., Prof., Head of Department ofUrology and Andrology, IPPE; Prof. at the Department of Endoscopic Urology; Head of Department of Urology Moscow, Russia

L. Pavlov

Republican Hospital No. 1 of the Republic of Sakha (Yakutia), National Center of Medicine

Head of the Department of Diagnostic and Interventional Radiology Yakutsk, Russia

参考

  1. Arnold M., Ferlay J., Forman D., Soerjomataram I., Karim-Kos H.E., Coebergh J.W., Byrnes G., Antilla A., Renehan A.G. Recent trends in incidence of five common cancers in 26 european countries since 1988: analysis of the European cancer observatory. Eur J Cancer. 2015;51 (9):1164-1187.
  2. Петров С.Б., Король В.Д., Григорьев В.Е. Паренхимо-сберегающая хирургия при раке почки. Современные подходы. Практическая онкология. 2012;13 (3):180-184
  3. Аляев Ю.Г., Крапивин А.А. Локализованный и местно распространенный рак почки: нефрэктомия или резекция? Онкоурология. 2005;1:10-15
  4. EAU Guidelines 2015, http://www.uroweb.org/guidelines/ onlineguidelines.
  5. Gill I.S., Kavoussi L.R., Lane B.R. et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J. Urol. 2007;178:41-46.
  6. Thompson R.H., Lane B.R., Lohse C.M., Leibovich B.C., Fergany A., Frank I., Gill I.S., Blute M.L., Campbell S.C. Renal function after partial nephrectomy: effect of warm ischemia relative to quantity and quality of preserved kidney. Urology. 2012;79(2): 356-360.
  7. Гусев А.А., Евсеев С.В., Коган М.И. Оценка почечных функций и оперативное лечение почечноклеточного рака. Онкоурология. 2013;1:17-23
  8. Есаян А.М., Аль-Шукри С.Х., Мосоян М.С. Почечноклеточный рак и хроническая болезнь почек: внимание к отдаленным неонкологическим исходам. Нефрология. 2012; 16(4): 94-99
  9. Мосоян М.С., Аль-Шукри С.Х., Семенов Д.Ю., Есаян А.М., Ильин Д.М. Селективная ишемия почечной паренхимы как альтернатива традиционному пережатию сосудистой ножки при резекции почки. Вестник урологии. 2014;3:3-11
  10. Thompson R.H., Lane B.R., Lohse C.M., Leibovich B.C., Fergany A., Frank I., Gill I.S., Blute M.L., Campbell S.C. Every minute counts when the renal hilum is clamped during partial nephrectomy. Eur Urol. 2010;58:340-345.
  11. Patel A.R. Warm ischemia less than 30 minutes is not necessarily safe during partial nephrectomy: every minute matters. Urol Oncol. 2011;29(6): 826-828.
  12. Marberger M., Pugh R.C., Auvert J., Bertermann H., Costantini A., Gammelgaard P.A., Petterson S., Wickham J.E. Conservative surgery of renal carcinoma: the EIRSS experience. Br. J. Urol. 1981;53(6):528-532.
  13. Ганзен Т.Н. Почечноклеточный рак: морфогенез, клинико-морфологическая характеристика, дифференциальная диагностика. Дисс. д-ра мед. наук. М., 1993
  14. Джавад-Заде М.Д., Льнев С.Н. Гомеостаз при операциях на органах мочеполовой системы. М.: Медицина; 1987. 240 c.
  15. Айвазян А.В. Гемостаз при операциях на почке. М.: Наука; 1982. 279 c.
  16. Есилевский Ю.М. Реография органов мочеполовой системы. М.: Медпресс-информ; 2004. 248 c.
  17. Максимов А.В., Мартов А.Г., Павлов Л.П., Неустроев П.А., Винокуров Р.Р. Лапароскопическая резекция почки с суперселективной баллонной эмболизацией почечной артерии. Урология. 2017; 1:31-36

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © Bionika Media, 2017
##common.cookie##