Effect of Warm Ischemia on Renal Function During Partial Nephrectomy: Assessment With New 99mTc-Mercaptoacetyltriglycine Scintigraphy Parameter
| Autor: | Takashi Fujita, Tokunori Yamamoto, Ryohei Hattori, Naoto Sassa, Yasuhito Funahashi, Momokazu Gotoh |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty 99mTc-Mercaptoacetyltriglycine Urology medicine.medical_treatment Renal function Nephron Kidney Function Tests Scintigraphy Nephrectomy Risk Assessment Technetium Tc 99m Mertiatide Cohort Studies Preoperative Care medicine Humans Neoplasm Invasiveness Prospective Studies Warm Ischemia Prospective cohort study Aged Neoplasm Staging Postoperative Care Kidney medicine.diagnostic_test business.industry Effective renal plasma flow Middle Aged Kidney Neoplasms Surgery Logistic Models Treatment Outcome medicine.anatomical_structure Multivariate Analysis Female business Radioisotope Renography Follow-Up Studies |
| Zdroj: | Urology. 79:160-164 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/j.urology.2011.08.071 |
| Popis: | Objective A decrease in renal function after partial nephrectomy caused by ischemic damage or nephron loss cannot be distinguished by conventional methods. We quantified renal function using a new 99m Tc-mercaptoacetyltriglycine ( 99m Tc-MAG3) renal scintigraphy parameter. Material and Methods We included 32 patients with a normally functioning contralateral kidney who received open partial nephrectomy with average warm ischemic time of 26.0 (range 14–46) min in this study. Effective renal plasma flow (ERPF) was calculated from 99m Tc-MAG3 renal scintigraphy before and at 1 week and 6 months after surgery. We also analyzed regional 99m Tc-MAG3 uptake in the surgically nonaffected parts. Results One week after surgery, average ERPF in the operated kidney decreased to 66.4% from baseline (from 177.8 to 116.9 mL/min/1.73 m 2 ) and regional 99m Tc-MAG3 uptake decreased to 83.4%. A stronger correlation was found between ischemic time and the decrease in regional 99m Tc-MAG3 uptake ( P P = .029). The decrease in regional 99m Tc-MAG3 uptake remained at 6 months in the group with ischemic time ≥25 minutes, whereas it recovered when ischemic time was Conclusion This new parameter quantified ischemic renal damage better than the conventional split functional evaluation. When warm ischemic time was ≥25 minutes, irreversible diffuse damage was seen in surgically preserved nephrons. |
| Databáze: | OpenAIRE |
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