Tsuru Ibuki, Kusakabe Masashi, Izumi Taro, Ono Akihiro, Muraki Yasuko, Teshima Taro, Amakawa Ryo, Inoue Yasushi, Yoshimatsu Tadashi, Morikawa Teppei, Kume Haruki, Kameyama Shuji, Shiga Yoshiyuki, Nakamura Masaki
Department of Urology, NTT Medical Center Tokyo, 5-9-22 Higashigotanda, Shinagawa-ku, Tokyo, 141-8625, Japan.
Department of Radiology, NTT Medical Center Tokyo, Tokyo, Japan.
Sci Rep. 2025 Jan 7;15(1):1164. doi: 10.1038/s41598-025-85362-y.
Partial nephrectomy has become the gold standard treatment for small renal masses. This study aimed to assess the impact of soft coagulation hemostasis on parenchymal volume reduction of the operated kidney after an open partial nephrectomy. We retrospectively reviewed 94 patients with small renal tumors who underwent open partial nephrectomy with soft-coagulation hemostasis at our institution. We measured the preoperative and postoperative renal volumes by computed tomography (CT) and calculated the renal volume reduction ratio as postoperative volume/preoperative volume. We performed multivariate analysis to identify the predictors of renal volume reduction. The median renal volume ratio was 0.75, and the median renal volume reduction rate was - 2.49 cm/month (IQR, - 3.33 to - 1.59). The RENAL score was inversely associated with ipsilateral renal volume reduction. In multivariate analysis, RENAL score, and tumor size were independent predictors of postoperative renal volume reduction. Soft coagulation hemostasis may influence the postoperative renal volume after partial nephrectomy, especially in patients with complex tumors.
肾部分切除术已成为小肾肿瘤的金标准治疗方法。本研究旨在评估软凝止血对开放性肾部分切除术后患肾实质体积减少的影响。我们回顾性分析了我院94例行开放性肾部分切除术并采用软凝止血的小肾肿瘤患者。通过计算机断层扫描（CT）测量术前和术后肾体积，并计算肾体积减少率（术后体积/术前体积）。我们进行多因素分析以确定肾体积减少的预测因素。肾体积比中位数为0.75，肾体积减少率中位数为-2.49 cm/月（四分位间距，-3.33至-1.59）。RENAL评分与患侧肾体积减少呈负相关。多因素分析显示，RENAL评分和肿瘤大小是术后肾体积减少的独立预测因素。软凝止血可能会影响肾部分切除术后的肾体积，尤其是对于复杂肿瘤患者。
