Comprehensive evaluation of renal function after laparoscopic partial nephrectomy for renal artery occlusion
Yang Xukai1 , Wang Yangmin1, Zhou Fenghai1, Dong Yunchao1, Chang Dehui1, Lyu Haidi1, Lan Tian1, Li Weipin1, Zhang Bin1, Kang Yindong1, Huang Chuang1, Peng Feng1
1.Department of Urology, Lanzhou General Hospital of Lanzhou Military Command, Lanzhou 730050, China)
Abstract：Objective: To evaluate the correlation between the time of renal artery clamping and the kidney function injury of 97 patients received retroperitoneal laparoscopic partial nephrectomy in our hospital within 4 years. Methods: Ninety-seven patients with renal carcinoma, who underwent retroperitoneal laparoscopic partial nephrectomy from July 2011 to March 2015, were divided into three groups. The group A contained 36 cases, the time of renal artery clamping were 17-25 min, the Male/Female ratio was 20/16, the mean age was (52.3±7.8) years old and the average tumor diameter was (2.9±0.5)cm; the group B contained 42 cases, the time of renal artery clamping were 26-30 min, the Male/Female ratio was 23/20, the mean age was (51.3±8.9) years old and the average tumor diameter was the group A contained 19 cases, the time of renal artery clamping were 30-45 min, the Male/Female ratio was 10/9, the mean age was (53.4±7.2) years old and the average tumor diameter was (3.0±0.7)cm. Results: The R.E.N.A.L. score in group A was (8.6±0.6); while it was (8.2±0.5) in group B, in group C, it was (9.2±0.6), When pairwise comparisons were made between each groups, the difference between group A and group B was no significant but was significant between group C and other two groups. The GRF before and 3 months after operation were compared. The difference between three groups was no significant before the operation (group A: 43.2±6.2 mL/min, group B: 45.3±4.7 mL/min, group C: 44.6±4.8 mL/min). There was also no significant difference between group A and group B after operation for 3 months (group A: 36.7±5.0 mL/min, group B: 38.3±4.7 mL/min, and yet group C (GRF:31.5±5.6 mL/min) had significant differences as compared with that of group A and group B after 3 month of operation. Conclusions: The time of renal artery occlusion was related to the R.E.N.A.L. score in retroperitoneal laparoscopic partial nephrectomy. Renal artery occlusion time should be controlled within 30 min.
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