The effects of warm ischaemia time on renal function after laparoscopic partial nephrectomy in patients with normal contralateral kidney

Abstract

Longer WIT was associated with LRF, as estimated with renal scintigraphy. LRF occurred within 3 months and remains stable until the 12th month after LPN. Every effort should be made to minimise warm ischaemic intervals during LPN, and the limit of 25 min should be not exceeded.

Comparison of renal functional outcomes in exactly matched pairs between robot-assisted partial nephrectomy using warm ischemia and open partial nephrectomy using cold ischemia using diethylene triamine penta-acetic acid renal scintigraphy

“…In addition, precise differences in ΔGFR were calculated in these matched pairs. A warm ischemia time of 20-25 min is regarded as the most reliable cutoff for preventing postoperative deterioration of renal function in an operated kidney [8][9][10]. This study found that wRAPN and cOPN resulted in similar postoperative renal functional outcomes in patients with an ischemia time of 20-25 min, confirming that 25 min is a reliable cutoff time for warm ischemia [22].…”

“…Propensity score analysis can account for differences in covariates between groups, allowing adjustments for variables associated with postoperative renal function. Before propensity score matching, age (<50 vs. ≥50 years), preoperative total GFR (<90 vs. ≥90 mL/ min/1.73 m 2 ), tumor size (<2 vs. ≥2 cm), and RENAL nephrometry score (low [4][5][6] vs. intermediate [7][8][9]) were dichotomized. For precise matching, ischemia time was divided into four categories (<20 vs. 20-25 vs. 25-30 vs. ≥30 min).…”

“…However, increased duration of renal ischemia may result in postoperative decrements in renal function in the residual operated-side renal parenchyma. Recent reports show that a warm ischemia time period of 20-25 min is a reliable cutoff for preventing renal functional deterioration [8][9][10]. Cold ischemia is recommended if a longer ischemia time is expected due to patient and tumor characteristics Abstract Purpose To compare renal functional outcomes in patients with a small renal mass undergoing robot-assisted partial nephrectomy using warm ischemia (wRAPN) or open partial nephrectomy using cold ischemia (cOPN).…”

Clampless laparoscopic partial nephrectomy: a step towards a harmless nephron-sparing surgery?

“…Functional results of PN have demonstrated that renal damage and subsequent loss of renal function occur even in cases of lower WIT, demonstrating that every minute counts when renal hilum is clamped (3,16).…”

Hemostatic techniques for kidney resection

“…Для этих целей используют лапароскопические зажимы типа «буль-дог», зажимы Сатинского или турникеты Руммеля [2]. Продол-жительность проведения лапароскопической резекции почки в условиях тепловой ишемии не должна превышать 25 мин, так как возрастает риск развития дисфункции органа в послеоперацион-ном периоде [3].…”