Superselective clamping of renal artery in laparoscopic partial nephrectomy: Primary experience sharing / 第二军医大学学报

ABSTRACT

Objective To evaluate the feasibility and safety of superselective renal artery clamping technique in laparoscopic partial nephrectomy and to assess its short-term effect on postoperative renal function. Methods Totally 23 patients, who were diagnosed as having renal malignant tumor and treated with transperitoneal laparoscopic partial nephrectomy by the same doctor at department of urology, Changhai Hospital from June 2013 to May 2014, were included in the present study. Superselective technique and traditional renal artery clamping technique were employed in group A (10 cases) and group B (13 cases), respectively. The operation time, intraoperative blood loss, postoperative renal function and other clinical parameters were compared between the two groups. Results Compared with group B, group A had significantly increased operation time ([257.60 ± 22.03] min vs [199.08 ± 36.70] min, P<0.05), intraoperative blood loss ([220 ± 57.01] mL vs [71.54 ± 30.51] mL, P<0.05) and postoperative incision drainage ([113.33 ± 24.82] mL vs [68.08 ± 28.88] mL, P<0.05), and there were no Grade III- complications such as massive bleeding or urinary leakage in the two groups. But patients in group A had slighter renal function damage postoperatively in the early stage compared with group B, as demonstrated by slighter eGFR decrease ([3.14 ± 7.22]% vs [15.26 ± 9.53]%, P<0.05) for a similar ischemic time ([28.60±8.17]) min vs ([27.85±6.16] min). Conclusion Superselective renal artery clamping does less harm to the kidney than traditional main renal artery clamping in laparoscopic partial nephrectomy, and it is worth further research for its benefit in early-stage renal function recovery postoperatively.