1
|
Bréhier G, Bouvier A, Besnier L, Willoteaux S, Nedelcu C, Culty T, Aubé C, Bigot P. Renal function after partial nephrectomy following intra-arterial embolization of renal tumors. Sci Rep 2020; 10:21352. [PMID: 33288819 PMCID: PMC7721888 DOI: 10.1038/s41598-020-78461-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/19/2020] [Indexed: 01/20/2023] Open
Abstract
Laparoscopic Partial Nephrectomy (LPN) after intra-arterial Embolization of renal tumors (LPNE) in a hybrid operating room allows renal tumor enucleation without dissection and clamping of the renal pedicle. The purpose was to assess the potential negative impact of embolization on the renal function. This prospective monocentric study included all patients treated with LPNE between May 2015 and June 2019. Clinical data was collected and incorporated into the UroCCR database (NCT03293563). Glomerular Filtration Rate (GFR) and Computed Tomography Renal Volume (CTRV) were compared before and after 6 months following LPNE. The mean post-operative GFR was 86.6 mL/min (SD 22.9). The mean GFR loss was 9.4% (SD 15.1) and the median renal parenchyma loss was 21 mL (SD 20.6). Using a threshold of 25% GFR loss, age was the only significant predictive factor of renal function impairment according to bivariate (59.5 vs 69.3 years, p = 0.017) and multivariable analysis (OR 1.075, CI 1–1.2], p = 0.05). Significant renal function impairment was not correlated with the renal parenchymal volume loss (OR 0.987, CI [0.95–1.02], p = 0.435). Renal function impairment after LPNE seems to be comparable to other techniques of partial nephrectomy.
Collapse
Affiliation(s)
- Germain Bréhier
- Radiology Department, University Hospital, CHU Angers, 4 rue Larrey, 49933, Angers, France.
| | - Antoine Bouvier
- Radiology Department, University Hospital, CHU Angers, 4 rue Larrey, 49933, Angers, France
| | - Louis Besnier
- Radiology Department, University Hospital, CHU Angers, 4 rue Larrey, 49933, Angers, France
| | - Serge Willoteaux
- Radiology Department, University Hospital, CHU Angers, 4 rue Larrey, 49933, Angers, France
| | - Cosmina Nedelcu
- Radiology Department, University Hospital, CHU Angers, 4 rue Larrey, 49933, Angers, France
| | - Thibaut Culty
- Urology Department, University Hospital, 49933, Angers, France
| | - Christophe Aubé
- Radiology Department, University Hospital, CHU Angers, 4 rue Larrey, 49933, Angers, France.,Laboratoire HIFIH, EA 3859, UNIV Angers, 49045, Angers, France
| | - Pierre Bigot
- Urology Department, University Hospital, 49933, Angers, France
| |
Collapse
|
2
|
Rassweiler JJ. Editorial Comment to Laparoscopic upper-pole heminephrectomy for duplicated renal collecting system with superselective artery clamping using virtual partial nephrectomy analysis of Synapse Vincent: A case report. Int J Urol 2015; 22:1077-8. [PMID: 26391657 DOI: 10.1111/iju.12953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jens J Rassweiler
- Department of Urology, SLK-Kliniken Heilbronn, University of Heidelberg, Heibronn, Germany.
| |
Collapse
|