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Urol Int ; 82(1): 24-7, 2009.
Article in English | MEDLINE | ID: mdl-19172092

ABSTRACT

AIMS: To evaluate whether transient renal artery clamping and external renal hypothermia cause any detrimental effect on the remaining renal parenchyma after nephron-sparing surgery with the use of (99m)Tc-DMSA-SPECT. METHODS: Twenty-eight patients with a unilateral renal mass but a normal contralateral kidney underwent nephron-sparing surgery. Serum biochemistry, 24-hour urinary creatinine clearance and absolute uptakes of the injected dose (%ID) of both kidneys as measured by renal (99m)Tc-DMSA-SPECT were compared preoperatively and in the 3rd postoperative month. (99m)Tc-DMSA uptakes in the contralateral kidney were used as controls. RESULTS: The average tumor size and mean renal artery clamping time were 37.4 +/- 11.3 (range 25-68) mm and 53.7 +/- 13 (range 38-90) min, respectively. Pre- and postoperative mean absolute uptakes of %ID in the remaining parenchyma of the operated kidneys were 15.13 +/- 3.30 and 14.74 +/- 3.38%, respectively (p = 0.052). In the contralateral kidneys, there was also no significant difference between the two studies (18.82 +/- 6.26 vs. 19.14 +/- 7.19%, respectively; p = 0.546). Likewise, there was no statistically significant difference between pre- and postoperative serum creatinine (p = 0.179) and creatinine clearance values (p = 0.108). CONCLUSION: Renal artery clamping and external cooling during nephron-sparing surgery have no demonstrable harmful effects on the renal parenchyma as measured by (99m)Tc-DMSA-SPECT analysis.


Subject(s)
Hypothermia, Induced , Ischemia/prevention & control , Kidney Neoplasms/surgery , Kidney/surgery , Nephrectomy/methods , Radiopharmaceuticals , Renal Artery/surgery , Technetium Tc 99m Dimercaptosuccinic Acid , Tomography, Emission-Computed, Single-Photon/methods , Adult , Aged , Constriction , Creatinine/blood , Female , Humans , Hypothermia, Induced/adverse effects , Ischemia/diagnostic imaging , Ischemia/etiology , Kidney/blood supply , Kidney/diagnostic imaging , Kidney Function Tests , Male , Middle Aged , Nephrectomy/adverse effects , Predictive Value of Tests , Prospective Studies , Time Factors , Treatment Outcome
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