We evaluated whether nephron sparing surgery (NSS) combined with meticulous suturing of the cut stump under clamping with cooling is beneficial for oncological outcomes and also assessed the relationship between cold ischemia time and deterioration of renal function.
One hundred and six patients with renal cell carcinoma (RCC) were subjected to this procedure. Oncological outcomes and renal function according to the estimated glomerular filtration rate (eGFR) and the tubular excretion rate on renoscintigraphy before and at 12 months after surgery were evaluated.
Cancer recurrences were observed in 2 patients with past history of RCC; however, no patient died of cancer. Renal function was evaluated depending on 4 different ischemia times. All groups did not show a remarkable decrease of renal function in terms of eGFR. Renoscintigraphy revealed the deterioration of the affected kidney in patients with >60 min ischemia.
The renoprotective procedure of NSS provided maximum preservation of renal function until 60 min of cold ischemia time.
Urologia internationalis. 2017 Jul 20 [Epub ahead of print]
Hayato Nishida, Atsushi Yamagishi, Mayu Yagi, Hidenori Kanno, Yuta Kurota, Toshihiko Sakurai, Sei Naito, Tomohiro Shibasaki, Hisashi Kawazoe, Osamu Ichiyanagi, Tomoyuki Kato, Akira Nagaoka, Yoshihiko Tomita, Norihiko Tsuchiya
Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan.