Jie Jiang1, Jian Qian1, Qian Zhang1, Shaobo Zhang1, Pu Li1, Chao Qin1, Jie Li1, Qiang Cao2, Pengfei Shao3. 1. Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. 2. Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. qiang_cao@126.com. 3. Division of Urology and Kidney Transplantation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. mnwkspf032@163.com.
Abstract
BACKGROUND: Laparoscopic partial nephrectomy (LPN) with segmental renal artery clamping has become an important method to minimize the warm ischemia of the kidney during the surgery. In the present study, we adopted a new model of calculating surgery-related kidney volume loss (SKVL), which was derived from the imaging technology to predict the outcomes of LPN with segmental renal artery clamping. METHODS: A total of 111 consecutive patients underwent LPN with available pre- and post-operation computed tomography (CT) scanning data were retrospectively analyzed. The SKVL was calculated using the parameter derived from the CT scan. The correlation between the SKVL and the perioperative outcomes as well as the renal function loss was estimated by the logistic regression analyses. RESULTS: The mean SKVL was 8.99 cm3; kidney volume and tumor volume was 147.48 cm3 and 25.87 cm3, respectively. The SKVL was associated with maximum diameter of tumor (P = 0.001), tumor volume (P < 0.001), intraoperative blood loss (P < 0.001), and the warm ischemia time (P = 0.004), but not associated with the surgery time (P = 0.322) and complications (P = 0.638). Besides, the SKVL was associated with the renal function loss after LPN (P < 0.001). The multivariable logistic regression showed that SKVL was an independent parameter to predict the renal function loss. CONCLUSIONS: SKVL is a pre-operation parameter derived from the imaging data, which may be used to predict the perioperative outcomes and renal function loss of patients undergoing LPN.
BACKGROUND: Laparoscopic partial nephrectomy (LPN) with segmental renal artery clamping has become an important method to minimize the warm ischemia of the kidney during the surgery. In the present study, we adopted a new model of calculating surgery-related kidney volume loss (SKVL), which was derived from the imaging technology to predict the outcomes of LPN with segmental renal artery clamping. METHODS: A total of 111 consecutive patients underwent LPN with available pre- and post-operation computed tomography (CT) scanning data were retrospectively analyzed. The SKVL was calculated using the parameter derived from the CT scan. The correlation between the SKVL and the perioperative outcomes as well as the renal function loss was estimated by the logistic regression analyses. RESULTS: The mean SKVL was 8.99 cm3; kidney volume and tumor volume was 147.48 cm3 and 25.87 cm3, respectively. The SKVL was associated with maximum diameter of tumor (P = 0.001), tumor volume (P < 0.001), intraoperative blood loss (P < 0.001), and the warm ischemia time (P = 0.004), but not associated with the surgery time (P = 0.322) and complications (P = 0.638). Besides, the SKVL was associated with the renal function loss after LPN (P < 0.001). The multivariable logistic regression showed that SKVL was an independent parameter to predict the renal function loss. CONCLUSIONS: SKVL is a pre-operation parameter derived from the imaging data, which may be used to predict the perioperative outcomes and renal function loss of patients undergoing LPN.
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