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肾射频消融术后的肾小球损失与30分钟的热缺血相当。

Glomerular Loss After Renal Radiofrequency Ablation Are Comparable to 30 Minutes of Warm Ischemia.

作者信息

Abreu Leonardo Albuquerque Dos Santos, Damasceno-Ferreira José Aurelino, Costa Waldemar Silva, Pereira-Sampaio Marco Aurélio, Sampaio Francisco José Barcellos, de Souza Diogo Benchimol

机构信息

1 Urogenital Research Unit, State University of Rio de Janeiro , Rio de Janeiro, Brazil .

2 Faculty of Medicine, Estacio de Sá University , Rio de Janeiro, Brazil .

出版信息

J Endourol. 2017 May;31(5):517-521. doi: 10.1089/end.2016.0899. Epub 2017 Apr 18.

Abstract

PURPOSE

To compare, with stereological methods, the glomerular loss in kidneys submitted to radiofrequency ablation (RFA) or warm ischemia.

MATERIALS AND METHODS

Twenty-six male pigs were divided into three groups. Eight animals were allocated in the sham group, which was submitted to laparoscopic dissection of the left renal hilum, without renal ischemia. Eight animals were allocated in the ischemia group, which had the left renal hilum clamped for 30 minutes under laparoscopic access. Ten animals were submitted to RFA of the left kidney lower pole, under laparoscopic visualization. Animals were euthanized 21 days after surgery, when kidneys were collected. Fragments of the upper pole of the left kidney were processed for morphometric analysis. Right kidney was used as self-controls for each animal. Glomerular volumetric density (Vv[glom]); volume-weighted glomerular volume (VWGV); and glomerular density were quantified by stereological methods and compared by Student's t-test and one-way-analysis of variance with Dunnett's post-test.

RESULTS

Three animals in the RFA group developed postoperative complications (Urinoma/Hydronephrosis) and were excluded from the analysis. No difference was found among the kidneys submitted to RFA and warm ischemia for all parameters. However, these kidneys showed lower Vv[glom] and glomerular density when compared to its self-controls (right kidneys), and when compared to sham-operated animals (p < 0.05). No difference was observed in regards to VWGV among the groups.

CONCLUSION

RFA in pigs determines a significant reduction of glomerular density in the remaining parenchyma. This alteration was comparable to that observed in kidneys submitted to 30 minutes of warm ischemia.

摘要

目的

采用体视学方法比较接受射频消融(RFA)或热缺血的肾脏中的肾小球损失情况。

材料与方法

26只雄性猪被分为三组。8只动物被分配到假手术组,接受左肾门的腹腔镜解剖,不进行肾缺血处理。8只动物被分配到缺血组,在腹腔镜直视下将左肾门夹闭30分钟。10只动物在腹腔镜直视下接受左肾下极的RFA。术后21天对动物实施安乐死并收集肾脏。将左肾上极的组织块进行形态计量分析。每只动物的右肾用作自身对照。通过体视学方法对肾小球体积密度(Vv[glom])、体积加权肾小球体积(VWGV)和肾小球密度进行量化,并通过Student's t检验和采用Dunnett事后检验的单因素方差分析进行比较。

结果

RFA组有3只动物出现术后并发症(尿囊肿/肾积水)并被排除在分析之外。在所有参数方面,接受RFA和热缺血的肾脏之间未发现差异。然而,与自身对照(右肾)相比,以及与假手术动物相比,这些肾脏的Vv[glom]和肾小球密度较低(p < 0.05)。各组之间在VWGV方面未观察到差异。

结论

猪的RFA可导致剩余实质中肾小球密度显著降低。这种改变与接受30分钟热缺血的肾脏中观察到的情况相当。

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