The correlation between affected renal function and affected renal residual volume: A retrospective outcome of laparoscopic nephron-sparing partial nephrectomy with segmental renal artery blocking-up for localized renal tumors

摘要

Laparoscopic nephron-sparing partial nephrectomy with segmental renal artery blocking (SRPN) has been widely used in the treatment of localized renal tumors. However, the impact of ischemia-reperfusion injury (IRI) during SRPN remains controversial. This study aims to evaluate the correlation between affected renal function and affected renal volume after SRPN for localized renal tumor treatment, explore the effect of IRI on renal function after SRPN. A total of 39 patients who underwent SRPN for localized renal tumor from June 2009 to April 2012 were reviewed. These patients were followed-up for 5 years. The preoperative affected renal glomerular filtration rate (aGFRsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"pre/sub), postoperative affected renal glomerular filtration rate (aGFRsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"post/sub), preoperative affected renal volume (aVolsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"pre/sub), and postoperative affected renal volume (aVolsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"post/sub) were collected during the follow-up period. The correlation between aGFRsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"post/sub/aGFRsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"pre/sub and aVolsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"post/sub/aVolsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"pre/sub was compared. A total of 33 patients were successfully followed up. After 3, 6, 12, 24, and 60 months, aGFRsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"post/sub was 34.6 ± 4.6, 34.7 ± 4.8, 34.9 ± 4.4, 35.1 ± 4.4, and 35.2 ± 4.2 mL/min. The correlation coefficients between aGFRsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"post/sub/aGFRsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"pre/sub and aVolsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"post/sub/aVolsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"pre/sub were 0.659 ( P = .000), 0.667 ( P = .000), 0.663 ( P = .000), 0.629 ( P = .000), and 0.604 ( P = .000), respectively. The limitation of this study was the small cohort size. For the localized renal tumor , aGFRsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"post/sub was associated with aVolsub xmlns:mrws="http://webservices.ovid.com/mrws/1.0"post/sub, but was not associated with intraoperative factors, such as the time of clamping of the affected segmental renal artery. As a part of nephrons, the resected tumor tissue caused the lack of inherent nephrons, resulting in the loss of renal function. More nephrons should be maintained before resecting the tumor completely during SRPN. Trial registration: ChiCTR-RRC-17011418.