Author/Authors :
Arslan, B İzmir Bozyaka Eğitim ve Araştırma Hastanesi - Üroloji Kliniği, Turkey , Önol, Ş Y Bezmialem Vakıf Üniversitesi - Tıp Fakültesi, Üroloji Kliniği, Turkey , Değirmenci, T İzmir Bozyaka Eğitim ve Araştırma Hastanesi - Üroloji Kliniği, Turkey , Kozacıoğlu, Z İzmir Bozyaka Eğitim ve Araştırma Hastanesi - Üroloji Kliniği, Turkey , Günlüsoy, B İzmir Bozyaka Eğitim ve Araştırma Hastanesi - Üroloji Kliniği, Turkey , Yonguç, T İzmir Bozyaka Eğitim ve Araştırma Hastanesi - Üroloji Kliniği, Turkey , Bozkurt, İ H İzmir Bozyaka Eğitim ve Araştırma Hastanesi - Üroloji Kliniği, Turkey
Abstract :
Aim: Different techniques are used to prevent bleeding during nephron-sparing renal surgery. In this study, our aim was to evaluate the results of partial nephrectomies performed with parenchymal clamping and pedicle clamping on postoperative renal function.Materials and Methods: The partial nephrectomy with parenchymal clamping and pedicle clamping technique was performed on 64 patients with renal cell carcinoma in our clinic. Operative time, ischemia time, and the total amount of blood loss was recorded. Creatinine levels were measured at the postoperative sixth month. Preoperative and postoperative glomerular filtration rates (GFR) were calculated using the Modification of Diet in Renal Disease formula. Patient age, basal metabolic index (BMI), tumor size, Fuhrman grade, ischemia time, operative time, amount of blood loss, preoperative and postoperative creatinine, and preoperative and postoperative GFR values were compared for both techniques. For statistical analysis, the student’s t test and paired sample t tests were used.Results: There was a statistically significant deterioration of creatinine and GFR values for both groups postoperatively (p 0.05). However, there was no statistically significant difference between the preoperative and postoperative values of creatinine and GFR values for both groups (p 0.05). The amount of blood loss was significantly higher with the parenchymal clamping technique (377±65 vs 243±80; p=0.001).Conclusion: Parenchymal and pedicle clamping techniques can be used successfully in patients undergoing partial nephrectomy for renal tumors. There is a similar reduction in GFR values and an increase in creatinin values in both techniques. Although it carries the risk of large amounts of bleeding, the parenchymal clamping technique seems more advantageous because it does not necessitate pedicle dissection.
