Falkowski Piotr, Jaromin Maciej, Ojdana Miłosz, Kutwin Piotr, Konecki Tomasz
1st Urology Clinic, University Clinical Hospital No. 2 of the Medical University of Lodz., 90-419 Lodz, Poland.
J Clin Med. 2024 Sep 16;13(18):5491. doi: 10.3390/jcm13185491.
Incidences of kidney cancers are steadily increasing. The surgical resection of renal tumors remains the treatment of choice, and different techniques provide similar oncological outcomes. Minimally invasive methods, especially partial nephrectomy (PN), have emerged as the preferred method of tumor resection, both in traditional and robot-assisted laparoscopy. PN may be performed as an open or laparoscopic operation. On-clamp PN is a variant of PN that includes the clamping of renal vessels; off-clamp PN is performed without any ischemia. : To assess the short-term loss of eGFR after on-clamp and off-clamp PN. : Data from 2021 to 2024 were retrospectively collected from a hospital database. The patients included in the study had a diagnosed kidney tumor that was confirmed by MRI or CT imaging. The patients were divided into two groups depending on the type of treatment they received: on-clamp PN or off-clamp PN. Hematocrit (HCT), hemoglobin (Hb) and eGFR were measured and compared. : Both groups had comparable preoperative HTC, Hb, and eGFR. eGFR loss 24 h after the procedure was 35.4% lower in the off-clamp group compared to the on-clamp group ( = 0.027). : Off-clamp PN is a safe and viable method for kidney tumor resection, both in traditional and robot-assisted laparoscopy. This technique results in a smaller perioperative loss of eGFR, which relates to better short-term functional outcomes than on-clamp PN.
肾癌的发病率正在稳步上升。肾肿瘤的手术切除仍然是首选治疗方法，不同的技术提供相似的肿瘤学治疗效果。微创方法，尤其是部分肾切除术（PN），在传统腹腔镜手术和机器人辅助腹腔镜手术中都已成为肿瘤切除的首选方法。PN可以通过开放手术或腹腔镜手术进行。钳夹式PN是PN的一种变体，包括钳夹肾血管；非钳夹式PN则在无任何缺血的情况下进行。目的：评估钳夹式和非钳夹式PN术后eGFR的短期下降情况。方法：回顾性收集2021年至2024年某医院数据库中的数据。纳入研究的患者经MRI或CT成像确诊患有肾肿瘤。根据患者接受的治疗类型将其分为两组：钳夹式PN组或非钳夹式PN组。测量并比较血细胞比容（HCT）、血红蛋白（Hb）和eGFR。结果：两组患者术前的HTC、Hb和eGFR具有可比性。术后24小时，非钳夹组的eGFR下降幅度比钳夹组低35.4%（P = 0.027）。结论：在传统腹腔镜手术和机器人辅助腹腔镜手术中，非钳夹式PN都是一种安全可行的肾肿瘤切除方法。该技术导致围手术期eGFR下降幅度较小，与钳夹式PN相比，其短期功能结局更好。
