Warm ischemia time length during on-clamp partial nephrectomy: does it really matter?

Raheem, Ali Abdel; Alowidah, Ibrahim; Capitanio, Umberto; Montorsi, Francesco; Larcher, Alessandro; Derweesh, Ithaar; Ghali, Fady; Mottrie, Alexander; Mazzone, Elio; Naeyer, Geert De; Campi, Riccardo; Sessa, Francesco; Carini, Marco; Minervini, Andrea; Raman, Jay D.; Rjepaj, Chris; Kriegmair, Maximilian C.; Autorino, Riccardo; Veccia, Alessandro; Mir, Maria Carmen; Claps, Francesco; Choi, Young Deuk; Ham, Won Sik; Tadifa, John Paul; Santok, Glen Denmer; Furlan, Maria; Simeone, Claudio; Bada, Maida; Celia, Antonio; Carrión, D.M.; Bazán, Alfredo Aguilera; Ruiz, Cristina Ballesteros; Malki, Manar; Barber, Neil; Hussain, Muddassar; Micali, Salvatore; Puliatti, Stefano; Alwahabi, Abdelaziz; Alqahtani, Abdulrahman; Rumaih, Abdullah; Ghaith, Ahmed; Ghoneem, Ayman M; Hagras, Ayman; Eissa, Ahmed; Alenzi, Mohamed Jayed; Pavan, Nicola; Traunero, Fabio; Antonelli, Alessandro; Porcaro, Antonio Benito; Illiano, Ester; Rha, Koon Ho

doi:10.23736/s2724-6051.21.04466-9

Cited by 22 publications

(4 citation statements)

References 41 publications

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“…This approach aimed to minimize renal acidosis and preserve renal function as much as possible. However, there remains controversy regarding the impact of warm ischemia time (WIT) on long-term renal function recovery, and Abdel et al ( 32 ) demonstrated that the duration of WIT during LPN does not affect long-term renal function outcomes. Furthermore, the potential impact of WIT on postoperative drainage has not been established yet.…”

Section: Discussionmentioning

confidence: 99%

Analysis of risk factors affecting the postoperative drainage after a laparoscopic partial nephrectomy: a retrospective study

Tian,

Ren,

Yin

et al. 2024

Front. Med.

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PurposeLaparoscopic partial nephrectomy (LPN) remains the most commonly used measure for treating localized renal cell cancer (RCC) with an increasing incidence of RCC ever since the 1990s. This study aimed to identify risk factors that affect the postoperative time of drainage and total drainage volume after LPN.MethodThe clinical data of 612 RCC patients who received LPN from January 2012 to December 2022 in our hospital, including the postoperative drainage time and total drainage volume, were retrospectively analyzed. Univariable and multivariable linear regression and correlation analyses were used to identify the correlations between 21 factors, which include gender, age, history of alcohol consumption, family history of RCC, body weight, body mass index (BMI), and operation time, postoperative drainage time, and total drainage volume.ResultsThe mean time of drainage was 3.52 ± 0.71 days (range: 2 to 8 days), with an average total drainage volume of 259.83 ± 72.64 mL (range: 50 to 620 mL). Both univariable and multivariable linear regression analyses revealed several statistically significant associations. Gender (p = 0.04), age (p = 0.008), smoking history (p < 0.001), diabetes (p = 0.032), operation time (p = 0.014), and BMI (p = 0.023) were identified as significant factors associated with the time of drainage. On the other hand, age (p = 0.008), smoking history (p < 0.001), diabetes (p = 0.006), and BMI (p = 0.016) emerged as independent risk factors influencing the total drainage volume.ConclusionThe duration of postoperative drainage was found to be associated with gender, age, smoking history, diabetes, operation time, and BMI. In contrast, the total drainage volume was primarily influenced by age, smoking history, diabetes, and high BMI following LPN. For patients with these conditions, meticulous attention to hemostasis and bleeding control is crucial during the perioperative period.

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Section: Discussionmentioning

confidence: 99%

Analysis of risk factors affecting the postoperative drainage after a laparoscopic partial nephrectomy: a retrospective study

Tian,

Ren,

Yin

et al. 2024

Front. Med.

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“…Studies have described the performance of partial nephrectomy without WI, which reduces the deterioration of the glomerular filtration rate ( 18 ). Raheem et al indicated that renal WI longer than 30 min was not associated with long-term chronic kidney disease in human patients with two kidneys ( 19 ). However, WI is associated with renal I/R injury ( 20 , 21 ) and the patient in the present case had severe bilateral renal involvement and grade 5 AKI.…”

Section: Discussionmentioning

confidence: 99%

Case report: Is bilateral renal dioctophymosis and severe uremia in a dog synonymous of euthanasia? Not today

Caye,

Gasparotto,

Hörbe

et al. 2024

Front. Vet. Sci.

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A dog with bilateral renal dioctophymosis presented with stage 5 acute kidney injury, weight loss, vomiting, apathy, and hematuria. Laboratory tests showed creatinine of 17.2 mg/dL and Dioctophyme renale eggs in the urine. It underwent a 30-min session of hyperbaric oxygen preconditioning at a pressure of 2 ATA. Subsequently, bilateral nephroscopy was performed, without warm ischemia, using Amplatz-type renal dilators. Five parasites were removed, three females from the right kidney, one female from the left kidney, and one male from the abdominal cavity. After surgery, the patient continued doing daily hyperbaric oxygen therapy (HBOT) sessions and clinical therapy. Postoperative care consisted of analgesics, antimicrobials, antioxidants, gastric protector and fluid therapy. Ultrasound monitoring showed a reduction in the area of renal dilation and the hematological and biochemical tests showed rapid recovery from acute kidney injury. There was no bacterial growth in the urine sample collected directly from the kidneys. The patient had an excellent clinical progression and was discharged from hospital 7 days postoperatively, with creatinine values of 2.9 mg/dL. This is the first report of the use of nephroscopy in the treatment of dioctophymosis and indicates excellent chances of cure even in severe cases of bilateral parasitosis. HBOT was shown to be an ally in the clinical therapy of patients with D. renale by helping with stabilization and postoperative recovery.

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“…Abdel Raheem et al. published a funding shows that WIT lengths during PN has no effect on the long-term renal function outcomes in patients having two kidneys and preoperative eGFR≥60 mL/min/1.73m2 ( 24 ). We believe that under certain conditions WIT may have little effect on renal function in patients as these authors suggest.…”

Section: Discussionmentioning

confidence: 99%

Clinical application of superselective transarterial embolization of renal tumors in zero ischaemia robotic-assisted laparoscopic partial nephrectomy

Li,

Hu,

et al. 2023

Front. Oncol.

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ObjectiveTo assess the feasibility and safety of zero ischaemia robotic-assisted laparoscopic partial nephrectomy (RALPN) after preoperative superselective transarterial embolization (STE) of T1 renal cancer.MethodsWe retrospectively analyzed the data of 32 patients who underwent zero ischaemia RALPN after STE and 140 patients who received standard robot-assisted laparoscopic partial nephrectomy (S-RALPN). In addition, we selected 35 patients treated with off-clamp RALPN (O-RALPN) from September 2017 to March 2022 for comparison. STE was performed by the same interventional practitioner, and zero ischaemia laparoscopic partial nephrectomy (LPN) was carried out by experienced surgeon 1-12 hours after STE. The intraoperative data and postoperative complications were recorded. The postoperative renal function, routine urine test, urinary Computed Tomography (CT), and preoperative and postoperative glomerular filtration rate (GFR) data were analyzed.ResultsAll operations were completed successfully. There were no cases of conversion to opening and no deaths. The renal arterial trunk was not blocked. No blood transfusions were needed. The mean operation time was 91.5 ± 34.28 minutes. The mean blood loss was 58.59 ± 54.11 ml. No recurrence or metastasis occurred.ConclusionFor patients with renal tumors, STE of renal tumors in zero ischaemia RALPN can preserve more renal function, and it provides a safe and feasible surgical method.

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Warm ischemia time length during on-clamp partial nephrectomy: does it really matter?

Cited by 22 publications

References 41 publications

Analysis of risk factors affecting the postoperative drainage after a laparoscopic partial nephrectomy: a retrospective study

Analysis of risk factors affecting the postoperative drainage after a laparoscopic partial nephrectomy: a retrospective study

Case report: Is bilateral renal dioctophymosis and severe uremia in a dog synonymous of euthanasia? Not today

Clinical application of superselective transarterial embolization of renal tumors in zero ischaemia robotic-assisted laparoscopic partial nephrectomy

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