Evaluation of renal function under controlled hypotension in zero ischemia robotic assisted partial nephrectomy

Ester Forastiere, Claudia Claroni, Maria Sofra, Giulia Torregiani, Marco Covotta, Maria Grazia Marchione, Diana Giannarelli, Rocco Papalia

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)181-185
Number of pages5
JournalKidney and Blood Pressure Research
Volume38
Issue number2-3
DOIs
Publication statusPublished - 2014

Keywords

  • 99mTc-Mercaptoacetyltriglycine
  • Hypotensive anaesthesia
  • Kidney neoplasms
  • Renal function
  • Robotic partial nephrectomy
  • Zero ischemia

ASJC Scopus subject areas

  • Nephrology
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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