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Impact of preoperative calculation of nephron volume loss on future of partial nephrectomy techniques; planning a strategic roadmap for improving functional preservation and securing oncological safety

Title
Impact of preoperative calculation of nephron volume loss on future of partial nephrectomy techniques; planning a strategic roadmap for improving functional preservation and securing oncological safety
Authors
Rha K.H.Abdel Raheem A.Park S.Y.Kim K.H.Kim H.J.Koo K.C.Choi Y.D.Jung B.H.Lee S.K.Lee W.K.Krishnan J.Shin T.Y.Cho J.-S.
Ewha Authors
김광현
SCOPUS Author ID
김광현scopus
Issue Date
2017
Journal Title
BJU International
ISSN
1464-4096JCR Link
Citation
vol. 120, no. 5, pp. 682 - 688
Keywords
kidney functionnephrectomyrenal cancer
Publisher
Blackwell Publishing Ltd
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Objectives: To assess the correlation of the resected and ischaemic volume (RAIV), which is a preoperatively calculated volume of nephron loss, with the amount of postoperative renal function (PRF) decline after minimally invasive partial nephrectomy (PN) in a multi-institutional dataset. Patients and Methods: We identified 348 patients from March 2005 to December 2013 at six institutions. Data on all cases of laparoscopic (n = 85) and robot-assisted PN (n = 263) performed were retrospectively gathered. Univariable and multivariable linear regression analyses were used to identify the associations between various time points of PRF and the RAIV, as a continuous variable. Results: The mean (sd) RAIV was 24.2 (29.2) cm3. The mean preoperative estimated glomerular filtration rate (eGFR) and the eGFRs at postoperative day 1, 6 and 36 months after PN were 91.0 and 76.8, 80.2 and 87.7 mL/min/1.73 m2, respectively. In multivariable linear regression analysis, the amount of decline in PRF at follow-up was significantly correlated with the RAIV (β 0.261, 0.165, 0.260 at postoperative day 1, 6 and 36 months after PN, respectively). This study has the limitation of its retrospective nature. Conclusion: Preoperatively calculated RAIV significantly correlates with the amount of decline in PRF during long-term follow-up. The RAIV could lead our research to the level of prediction of the amount of PRF decline after PN and thus would be appropriate for assessing the technical advantages of emerging techniques. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd
DOI
10.1111/bju.13937
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의과대학 > 의학과 > Journal papers
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