ABSTRACT
BACKGROUND: The increase of intraabdominal pressure to 10 mmHg provokes a decrease of renal blood flow (RBF). Pneumoperitoneum during laparoscopic techniques with intra-abdominal pressure (IAP) to 15 mmHg, results in a decrease in RBF, urine output and glomerular filtration rate (GFR). PURPOSE: Analyze the changes in RBF, urine output an GFR in a porcine experimental model during open vs laparoscopic nephrectomy. MATERIALS AND METHODS: 30 pigs (medium weigh= 22.6+3.2 Kg) were divided into two groups: Laparoscopic nephrectomy was performed using 15 pigs and open nephrectomy in 15 pigs, following a living donor nephrectomy autotransplantation model. Study parameters were urine volume and GFR baseline values, 30 and 60 minutes during nephrectomy. RBF was measured using an electromagnetic flow catheter around the main renal artery during the initial 60 minutes of nephrectomy. RESULTS: The laparoscopic technique was associated with a significant reduction of RBF (80+2.7 vs 262+3 ml/min) (p<0.005), diuresis (42%) and GFR (38%), vs the open group. CONCLUSIONS: Laparoscopic nephrectomy involves a significant reduction of RBF, GFR and diuresis, which is potentially transcendent in living donor nephrectomy and kidney transplantation.