Efficacy of parenchymal compression in open partial nephrectomies: A comparison with conventional vascular clamping

Hwii Ko Young, Hoon Choi, Sung-Gu Kang, Seok Ho Kang, Hong Seok Park, Jun Cheon, Jeong Gu Lee, Je-Jong Kim, Ki Yoon Duck

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Abstract

Purpose: We evaluated the efficacy of parenchymal compression in open partial nephrectomies (OPNs) compared with that of the conventional vascular clamping method. Materials and Methods: OPNs were conducted by means of the parenchymal compression technique at our institution from April 2006. Among these, the operative outcomes of 20 consecutive patients with normal preoperative renal function (Group 1) were matched with those of 20 control patients from the database of previous operations who underwent OPN with a conventional vascular clamping method (Group 2). Results: All preoperative characteristics were similar in both groups. The operative time was significantly higher for Group 2 (132.4±17.7 vs. 151.4±21.4 minutes, p=0.031). Estimated blood loss was slightly higher for Group 2, with marginal statistical significance (173.7±11.5 vs. 211.2±43.8 ml, p=0.06). Histologic examination revealed that over 80% of the tumors in both groups were renal cell carcinomas. For all patients, the pathology results of specimens were negative. Serum creatinine, checked at 1, 3, and 7 days after the operation, was significantly increased in both groups to a similar degree. However, 30 days after surgery, the patterns of serial serum creatinine levels demonstrated statistically significant differences by repeated-measures ANOVA (p<0.001), with a trend of more elevated in Group 2 than in Group 1, although values were within the normal range. No major complications occurred in either group. Conclusions: OPN using the parenchymal compression method had acceptable outcomes in terms of complete tumor control, avoiding warm ischemic time, and minimizing blooding, with good preservation of renal function and minimal complications.

Original languageEnglish
Pages (from-to)8-13
Number of pages6
JournalKorean Journal of Urology
Volume51
Issue number1
DOIs
Publication statusPublished - 2010 Jan 1

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Nephrectomy
Constriction
Blood Vessels
Creatinine
Kidney
Warm Ischemia
Operative Time
Serum
Ambulatory Surgical Procedures
Renal Cell Carcinoma
Neoplasms
Analysis of Variance
Reference Values
Databases
Pathology

Keywords

  • Kidney neoplasms
  • Nephrectomy
  • Organ preservation

ASJC Scopus subject areas

  • Urology

Cite this

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title = "Efficacy of parenchymal compression in open partial nephrectomies: A comparison with conventional vascular clamping",
abstract = "Purpose: We evaluated the efficacy of parenchymal compression in open partial nephrectomies (OPNs) compared with that of the conventional vascular clamping method. Materials and Methods: OPNs were conducted by means of the parenchymal compression technique at our institution from April 2006. Among these, the operative outcomes of 20 consecutive patients with normal preoperative renal function (Group 1) were matched with those of 20 control patients from the database of previous operations who underwent OPN with a conventional vascular clamping method (Group 2). Results: All preoperative characteristics were similar in both groups. The operative time was significantly higher for Group 2 (132.4±17.7 vs. 151.4±21.4 minutes, p=0.031). Estimated blood loss was slightly higher for Group 2, with marginal statistical significance (173.7±11.5 vs. 211.2±43.8 ml, p=0.06). Histologic examination revealed that over 80{\%} of the tumors in both groups were renal cell carcinomas. For all patients, the pathology results of specimens were negative. Serum creatinine, checked at 1, 3, and 7 days after the operation, was significantly increased in both groups to a similar degree. However, 30 days after surgery, the patterns of serial serum creatinine levels demonstrated statistically significant differences by repeated-measures ANOVA (p<0.001), with a trend of more elevated in Group 2 than in Group 1, although values were within the normal range. No major complications occurred in either group. Conclusions: OPN using the parenchymal compression method had acceptable outcomes in terms of complete tumor control, avoiding warm ischemic time, and minimizing blooding, with good preservation of renal function and minimal complications.",
keywords = "Kidney neoplasms, Nephrectomy, Organ preservation",
author = "Young, {Hwii Ko} and Hoon Choi and Sung-Gu Kang and Kang, {Seok Ho} and Park, {Hong Seok} and Jun Cheon and Lee, {Jeong Gu} and Je-Jong Kim and Duck, {Ki Yoon}",
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T1 - Efficacy of parenchymal compression in open partial nephrectomies

T2 - A comparison with conventional vascular clamping

AU - Young, Hwii Ko

AU - Choi, Hoon

AU - Kang, Sung-Gu

AU - Kang, Seok Ho

AU - Park, Hong Seok

AU - Cheon, Jun

AU - Lee, Jeong Gu

AU - Kim, Je-Jong

AU - Duck, Ki Yoon

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N2 - Purpose: We evaluated the efficacy of parenchymal compression in open partial nephrectomies (OPNs) compared with that of the conventional vascular clamping method. Materials and Methods: OPNs were conducted by means of the parenchymal compression technique at our institution from April 2006. Among these, the operative outcomes of 20 consecutive patients with normal preoperative renal function (Group 1) were matched with those of 20 control patients from the database of previous operations who underwent OPN with a conventional vascular clamping method (Group 2). Results: All preoperative characteristics were similar in both groups. The operative time was significantly higher for Group 2 (132.4±17.7 vs. 151.4±21.4 minutes, p=0.031). Estimated blood loss was slightly higher for Group 2, with marginal statistical significance (173.7±11.5 vs. 211.2±43.8 ml, p=0.06). Histologic examination revealed that over 80% of the tumors in both groups were renal cell carcinomas. For all patients, the pathology results of specimens were negative. Serum creatinine, checked at 1, 3, and 7 days after the operation, was significantly increased in both groups to a similar degree. However, 30 days after surgery, the patterns of serial serum creatinine levels demonstrated statistically significant differences by repeated-measures ANOVA (p<0.001), with a trend of more elevated in Group 2 than in Group 1, although values were within the normal range. No major complications occurred in either group. Conclusions: OPN using the parenchymal compression method had acceptable outcomes in terms of complete tumor control, avoiding warm ischemic time, and minimizing blooding, with good preservation of renal function and minimal complications.

AB - Purpose: We evaluated the efficacy of parenchymal compression in open partial nephrectomies (OPNs) compared with that of the conventional vascular clamping method. Materials and Methods: OPNs were conducted by means of the parenchymal compression technique at our institution from April 2006. Among these, the operative outcomes of 20 consecutive patients with normal preoperative renal function (Group 1) were matched with those of 20 control patients from the database of previous operations who underwent OPN with a conventional vascular clamping method (Group 2). Results: All preoperative characteristics were similar in both groups. The operative time was significantly higher for Group 2 (132.4±17.7 vs. 151.4±21.4 minutes, p=0.031). Estimated blood loss was slightly higher for Group 2, with marginal statistical significance (173.7±11.5 vs. 211.2±43.8 ml, p=0.06). Histologic examination revealed that over 80% of the tumors in both groups were renal cell carcinomas. For all patients, the pathology results of specimens were negative. Serum creatinine, checked at 1, 3, and 7 days after the operation, was significantly increased in both groups to a similar degree. However, 30 days after surgery, the patterns of serial serum creatinine levels demonstrated statistically significant differences by repeated-measures ANOVA (p<0.001), with a trend of more elevated in Group 2 than in Group 1, although values were within the normal range. No major complications occurred in either group. Conclusions: OPN using the parenchymal compression method had acceptable outcomes in terms of complete tumor control, avoiding warm ischemic time, and minimizing blooding, with good preservation of renal function and minimal complications.

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