Long-term Renal Function Following Zero Ischemia Partial Nephrectomy

Overview

Journal Res Rep Urol

Publisher Dove Medical Press

Specialty Urology

Date 2019 Mar 19

PMID 30881944

Citations 2

Authors

Mehmet Salih Boga

Mehmet Giray Sonmez

Affiliations

Soon will be listed here.

Abstract

Partial nephrectomy (PN), also known as nephron sparing surgery, is considered as the first-line treatment in small renal masses, especially in T1/2 tumors, and is applied as a standard treatment in advanced centers. The main expected outcomes from an ideal PN are surgical margin negativity, minimal impairment in renal function, and any surgical complications. Many authors have defined PN techniques as "zero ischemia partial nephrectomy", where surgery is performed without clamping the main renal artery in order to protect the renal parenchyma from ischemic injury. Various PN techniques employed by surgeons include: selective or segmental renal artery clamping technique; off-clamp, clampless, or unclamped technique; preoperative superselective transarterial tumor embolization technique; sequential/modified sequential preplaced suture renorrhaphy technique, radio frequency ablation-assisted technique, and combination of these techniques. The common goal of all these techniques is to provide zero ischemia without hilar clamping. This systematic review focuses on the long-term functional outcomes of PNs performed by zero ischemia techniques.

Citing Articles

The efficacy of modified binding technique for renorrhaphy during robotic partial nephrectomy: surgical and functional outcomes from single-center experience.

Wang Z, Zhang W, Yu S, Zhan Y, Fan Y, Zhang X Surg Endosc. 2022; 37(1):391-401.

PMID: 35982285 PMC: 9839798. DOI: 10.1007/s00464-022-09460-y.

Changes in kidney function according to ischemia type during partial nephrectomy for T1a kidney cancer.

Lee J, Hwang Y, Yoo S, Choo M, Cho M, Son H Sci Rep. 2022; 12(1):4223.

PMID: 35273257 PMC: 8913619. DOI: 10.1038/s41598-022-07919-5.

References

Cadeddu J, Corwin T . Cable tie compression to facilitate laparoscopic partial nephrectomy. J Urol. 2000; 165(1):177-8. DOI: 10.1097/00005392-200101000-00043. View

Cadeddu J, Corwin T, Traxer O, Collick C, Saboorian H, Pearle M . Hemostatic laparoscopic partial nephrectomy: cable-tie compression. Urology. 2001; 57(3):562-6. DOI: 10.1016/s0090-4295(00)01009-8. View

Lotan Y, Gettman M, Ogan K, Baker L, Cadeddu J . Clinical use of the holmium: YAG laser in laparoscopic partial nephrectomy. J Endourol. 2002; 16(5):289-92. DOI: 10.1089/089277902760102767. View

Moinzadeh A, Gill I, Rubenstein M, Ukimura O, Aron M, Spaliviero M . Potassium-titanyl-phosphate laser laparoscopic partial nephrectomy without hilar clamping in the survival calf model. J Urol. 2005; 174(3):1110-4. DOI: 10.1097/01.ju.0000168620.36893.6c. View

Shekarriz B . Hydro-Jet technology in urologic surgery. Expert Rev Med Devices. 2005; 2(3):287-91. DOI: 10.1586/17434440.2.3.287. View

Wen C, Nakada S . Energy ablative techniques for treatment of small renal tumors. Curr Opin Urol. 2006; 16(5):321-6. DOI: 10.1097/01.mou.0000240302.11379.5b. View

Thompson R, Frank I, Lohse C, Saad I, Fergany A, Zincke H . The impact of ischemia time during open nephron sparing surgery on solitary kidneys: a multi-institutional study. J Urol. 2007; 177(2):471-6. DOI: 10.1016/j.juro.2006.09.036. View

Gallucci M, Guaglianone S, Carpanese L, Papalia R, Simone G, Forestiere E . Superselective embolization as first step of laparoscopic partial nephrectomy. Urology. 2007; 69(4):642-5. DOI: 10.1016/j.urology.2006.10.048. View

Kutikov A, Vanarsdalen K, Gershman B, Fossett L, Guzzo T, Wein A . Enucleation of renal cell carcinoma with ablation of the tumour base. BJU Int. 2008; 102(6):688-91. DOI: 10.1111/j.1464-410X.2008.07661.x. View

10.

Nohara T, Fujita H, Yamamoto K, Kitagawa Y, Gabata T, Namiki M . Modified anatrophic partial nephrectomy with selective renal segmental artery clamping to preserve renal function: a preliminary report. Int J Urol. 2008; 15(11):961-6. DOI: 10.1111/j.1442-2042.2008.02141.x. View

11.

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009; 6(7):e1000100. PMC: 2707010. DOI: 10.1371/journal.pmed.1000100. View

12.

Ficarra V, Novara G, Secco S, Macchi V, Porzionato A, De Caro R . Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol. 2009; 56(5):786-93. DOI: 10.1016/j.eururo.2009.07.040. View

13.

Thiex R, Norbash A, Frerichs K . The safety of dedicated-team catheter-based diagnostic cerebral angiography in the era of advanced noninvasive imaging. AJNR Am J Neuroradiol. 2009; 31(2):230-4. PMC: 7964127. DOI: 10.3174/ajnr.A1803. View

14.

Colli J, Martin B, Purcell M, Kim Y, Busby E . Surgical factors affecting return of renal function after partial nephrectomy. Int Urol Nephrol. 2010; 43(1):131-7. DOI: 10.1007/s11255-010-9764-1. View

15.

Thompson R, Lane B, Lohse C, Leibovich B, Fergany A, Frank I . Every minute counts when the renal hilum is clamped during partial nephrectomy. Eur Urol. 2010; 58(3):340-5. DOI: 10.1016/j.eururo.2010.05.047. View

16.

Gill I, Eisenberg M, Aron M, Berger A, Ukimura O, Patil M . "Zero ischemia" partial nephrectomy: novel laparoscopic and robotic technique. Eur Urol. 2010; 59(1):128-34. DOI: 10.1016/j.eururo.2010.10.002. View

17.

Smith G, Kenney P, Lee Y, Libertino J . Non-clamped partial nephrectomy: techniques and surgical outcomes. BJU Int. 2010; 107(7):1054-8. DOI: 10.1111/j.1464-410X.2010.09798.x. View

18.

Lane B, Gill I, Fergany A, Larson B, Campbell S . Limited warm ischemia during elective partial nephrectomy has only a marginal impact on renal functional outcomes. J Urol. 2011; 185(5):1598-603. DOI: 10.1016/j.juro.2010.12.046. View

19.

Simone G, Papalia R, Guaglianone S, Carpanese L, Gallucci M . Zero ischemia laparoscopic partial nephrectomy after superselective transarterial tumor embolization for tumors with moderate nephrometry score: long-term results of a single-center experience. J Endourol. 2011; 25(9):1443-6. DOI: 10.1089/end.2010.0684. View

20.

Ukimura O, Nakamoto M, Gill I . Three-dimensional reconstruction of renovascular-tumor anatomy to facilitate zero-ischemia partial nephrectomy. Eur Urol. 2011; 61(1):211-7. DOI: 10.1016/j.eururo.2011.07.068. View