TY - JOUR
T1 - Evaluation of renal function under controlled hypotension in zero ischemia robotic assisted partial nephrectomy
AU - Forastiere, Ester
AU - Claroni, Claudia
AU - Sofra, Maria
AU - Torregiani, Giulia
AU - Covotta, Marco
AU - Marchione, Maria Grazia
AU - Giannarelli, Diana
AU - Papalia, Rocco
PY - 2014
Y1 - 2014
N2 - Background/Aims: In partial nephrectomy with hilar clamping every minute of ischemia can impair renal function, thus great importance is having the controlled hypotension as a part of zero ischemia technique. The aim of the study is to evaluate the effects of hypotensive anesthesia on renal function, in patients undergoing robotic assisted partial nephrectomy (RAPN) , during surgery and at 3 months follow up. Methods: This is a prospective study of 100 patients, ASA 1-2, who underwent zero ischemia RAPN under controlled hypotension (CH) from December 2011 through to May 2013. Serum creatinine, BUN, estimated glomerular filtration rates (eGFR), fractional excretion of sodium (FSE) and technetium Tc 99m mercaptoacetyltriglycine (99mTC-MAG-3), renal scintigraphy with effective renal plasma flow (ERPF) were evaluated. Results: Mean duration of CH was 50±4 minutes. Acute renal failure wasn't observed in any of the patients. A significant variation of eGFR during the procedure and 24 hours after surgery was observed. No significant variation of BUN and FSE was detected. Comparing preoperative ERPF of the operated kidney with ERPF 3 months after surgery, it decreased by 2%. Conclusion: In patients with normal preoperative renal function CH didn't show any detrimental impact on renal function during and after robotic assisted partial nephrectomy.
AB - Background/Aims: In partial nephrectomy with hilar clamping every minute of ischemia can impair renal function, thus great importance is having the controlled hypotension as a part of zero ischemia technique. The aim of the study is to evaluate the effects of hypotensive anesthesia on renal function, in patients undergoing robotic assisted partial nephrectomy (RAPN) , during surgery and at 3 months follow up. Methods: This is a prospective study of 100 patients, ASA 1-2, who underwent zero ischemia RAPN under controlled hypotension (CH) from December 2011 through to May 2013. Serum creatinine, BUN, estimated glomerular filtration rates (eGFR), fractional excretion of sodium (FSE) and technetium Tc 99m mercaptoacetyltriglycine (99mTC-MAG-3), renal scintigraphy with effective renal plasma flow (ERPF) were evaluated. Results: Mean duration of CH was 50±4 minutes. Acute renal failure wasn't observed in any of the patients. A significant variation of eGFR during the procedure and 24 hours after surgery was observed. No significant variation of BUN and FSE was detected. Comparing preoperative ERPF of the operated kidney with ERPF 3 months after surgery, it decreased by 2%. Conclusion: In patients with normal preoperative renal function CH didn't show any detrimental impact on renal function during and after robotic assisted partial nephrectomy.
KW - 99mTc-Mercaptoacetyltriglycine
KW - Hypotensive anaesthesia
KW - Kidney neoplasms
KW - Renal function
KW - Robotic partial nephrectomy
KW - Zero ischemia
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U2 - 10.1159/000355766
DO - 10.1159/000355766
M3 - Article
C2 - 24732055
AN - SCOPUS:84897968365
VL - 38
SP - 181
EP - 185
JO - Kidney and Blood Pressure Research
JF - Kidney and Blood Pressure Research
SN - 1420-4096
IS - 2-3
ER -