Atılgan Doğan, Kılıç Şahin, Gençten Yusuf, Uluocak Nihat, Fırat Fatih, Kölükçü Engin, Parlaktaş Bekir Süha
Department of Urology, Gaziosmanpasa University Faculty of Medicine, Tokat, Turkey.
Clinic of Urololgy, Turhal State Hospital, Tokat, Turkey.
Turk J Urol. 2014 Jun;40(2):93-8. doi: 10.5152/tud.2014.92063.
Herein, the impact of off-clamp open partial nephrectomy on early postoperative period renal functions were evaluated in patients with low RENAL nephrometry scoring small renal masses.
Twenty-three patients (12 women, and 11 men) who had undergone non-hilar clamping open partial nephrectomy in our clinic between the years 2010, and 2013 were retrospectively evaluated. Mean age, body mass index (BMI), operative time, blood loss, renal nephrometry score, mean hospital stay, pre-, and postoperative serum creatinine (Cr), and glomerular filtration rate (GFR) of the patients were assessed.
Mean age, BMI, tumor size, and preoperative renal nephrometry scores were 56.09±10.49 years (36-70 yrs), 24.81±2.44 kg/m(2), 3.68±1.125 cm, and 6.41±1.77 pts, respectively. Mean operative time, intraoperative blood loss, and hospital stay were detected as 139.14±33.60 min, 274.9±77.02 mL, and 4.27±1.12 days, respectively. Preoperative mean serum Cr, and GFR levels were 0.804±0.216 mg/dL, and 93.97±25.83 mL/min/1.73 m(2), respectively. Postoperative 1. day mean serum Cr, and GFR levels were 0.896±0.25 mg/dL, and 85.94±28.85 mL/min/1,73 m(2), while corresponding 3. month-values were 0.81±0.205 mg/dL, and 93.59±21.00 mL/dk/1.73 m(2), respectively. A statistically significant difference was not found between preoperative, and postoperative 3. month- serum Cr, and GFR levels. However, postoperative 3. month-serum Cr, and GFR levels were lower than corresponding values estimated on postoperative 1. day (p<0.016).
One of the important considerations in partial nephrectomy is to preserve renal functions. Therefore, non-hilar clamping open partial nephrectomy should be taken into consideration for surgeons unexperienced especially in laparoscopic surgery with its lower morbidity, and complication rates.
评估非肾门阻断开放式部分肾切除术对RENAL肾计量评分低的小肾肿块患者术后早期肾功能的影响。
回顾性评估2010年至2013年间在我院接受非肾门阻断开放式部分肾切除术的23例患者（12例女性，11例男性）。评估患者的平均年龄、体重指数（BMI）、手术时间、失血量、肾计量评分、平均住院时间、术前和术后血清肌酐（Cr）以及肾小球滤过率（GFR）。
平均年龄、BMI、肿瘤大小和术前肾计量评分分别为56.09±10.49岁（36 - 70岁）、24.81±2.44kg/m²、3.68±1.125cm和6.41±1.77分。平均手术时间、术中失血量和住院时间分别为139.14±33.60分钟、274.9±77.02毫升和4.27±1.12天。术前平均血清Cr和GFR水平分别为0.804±0.216mg/dL和93.97±25.83mL/min/1.73m²。术后第1天平均血清Cr和GFR水平分别为0.896±0.25mg/dL和85.94±28.85mL/min/1.73m²，而相应的3个月值分别为0.81±0.205mg/dL和93.59±21.00mL/dk/1.73m²。术前与术后3个月的血清Cr和GFR水平之间未发现统计学上的显著差异。然而，术后3个月的血清Cr和GFR水平低于术后第1天估计的相应值（p<0.016）。
部分肾切除术的一个重要考虑因素是保留肾功能。因此，对于尤其是缺乏腹腔镜手术经验的外科医生而言，非肾门阻断开放式部分肾切除术因其较低的发病率和并发症发生率应予以考虑。
