Masayuki Nanri1, Kazuma Udo2, Maki Kawasaki2, Yuji Tokuda2, Chisato Fujiyama2, Jiro Uozumi2, Shuji Toda3. 1. Department of Urology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan. nanriman@gmail.com. 2. Department of Urology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan. 3. Department of Pathology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
Abstract
BACKGROUND: We assessed the extent of apoptotic damage induced by the microwave tissue coagulator (MTC) in the preserved normal renal tissue following partial nephrectomy. METHODS: Eleven patients who underwent nonischemic partial nephrectomy with MTC (group M) were enrolled in this study. The other 11 patients who underwent cold-ischemic partial nephrectomy without the use of MTC were enrolled as controls (group C). There were no significant differences in tumor size or age between the two groups. Renal damage was evaluated by counting apoptotic cells in the normal renal tissue surrounding the tumor tissue. Immunohistochemical staining with single-stranded DNA was carried out to investigate the apoptotic cells. RESULTS: The number of apoptotic cells in group M ranged from 275 to 508 per 1,000 cells, with a median value of 421. The number in group C ranged from 122 to 466 per 1,000 cells with a median value of 286. The number of apoptotic cells in group M was significantly greater than that in group C (p = 0.006). Blood loss in group C was significantly greater than that in group M (p < 0.0001). CONCLUSIONS: This study points out that renal damage induced by the use of MTC comprises not only necrosis but also apoptotic change. Although MTC is useful for controlling renal parenchymal bleeding during partial nephrectomy, we must consider that renal apoptotic damage caused by the MTC may spread beyond the coagulated necrosis area.
BACKGROUND: We assessed the extent of apoptotic damage induced by the microwave tissue coagulator (MTC) in the preserved normal renal tissue following partial nephrectomy. METHODS: Eleven patients who underwent nonischemic partial nephrectomy with MTC (group M) were enrolled in this study. The other 11 patients who underwent cold-ischemic partial nephrectomy without the use of MTC were enrolled as controls (group C). There were no significant differences in tumor size or age between the two groups. Renal damage was evaluated by counting apoptotic cells in the normal renal tissue surrounding the tumor tissue. Immunohistochemical staining with single-stranded DNA was carried out to investigate the apoptotic cells. RESULTS: The number of apoptotic cells in group M ranged from 275 to 508 per 1,000 cells, with a median value of 421. The number in group C ranged from 122 to 466 per 1,000 cells with a median value of 286. The number of apoptotic cells in group M was significantly greater than that in group C (p = 0.006). Blood loss in group C was significantly greater than that in group M (p < 0.0001). CONCLUSIONS: This study points out that renal damage induced by the use of MTC comprises not only necrosis but also apoptotic change. Although MTC is useful for controlling renal parenchymal bleeding during partial nephrectomy, we must consider that renal apoptotic damage caused by the MTC may spread beyond the coagulated necrosis area.
Authors: Tim G A M Wolfs; Bart de Vries; Sarah J Walter; Carine J Peutz-Kootstra; L W Ernest van Heurn; Gosse O N Oosterhof; Wim A Buurman Journal: Am J Transplant Date: 2005-01 Impact factor: 8.086