Recovery of renal function after open and laparoscopic partial nephrectomy Journal Article

  


Authors: Adamy, A.; Favaretto, R. L.; Nogueira, L.; Savage, C.; Russo, P.; Coleman, J.; Guillonneau, B.; Touijer, K.
Article Title: Recovery of renal function after open and laparoscopic partial nephrectomy
Abstract: Background: Although oncologic outcomes appear to be similar after laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN), data on renal function are lacking. Objective: To evaluate the change over time in renal function after LPN and OPN. Design, setting, and participants: We identified 987 patients with a single sporadic tumor and a normal contralateral kidney who were treated by LPN (n = 182) and OPN (n = 805) between January 2002 and July 2009. Intervention: All patients underwent LPN or OPN at Memorial Sloan-Kettering Cancer Center. Measurements: Estimated glomerular filtration rate (GFR) was calculated using the abbreviated Modification of Diet in Renal Disease formula. We created a multivariable generalized estimating equations linear model that predicted GFR based on the time from surgery, preoperative GFR, tumor size, American Society of Anesthesiologists score, and ischemia time. Results and limitations: Mean patient age, tumor size, and ASA score were similar between LPN and OPN patients. The baseline preoperative GFR was lower in the laparoscopic group (67 ml/min per 1.73 m2 vs 73 ml/min per 1.73 m2; p < 0.001). The mean ischemia time was shorter after LPN than OPN (35 min vs 40 min, respectively; p < 0.001). In a multivariable model, the interaction term between time from surgery and approach was statistically significant (p = 0.045), indicating that there was a differential effect on recovery of renal function over time by approach. Laparoscopically treated patients maintained a slightly higher renal function than those treated via an open approach. The 2-mo and 6-mo predicted GFR for a typical patient increased slightly from 65 ml/min per 1.73 m2 to 67 ml/min per 1.73 m 2, respectively, for those treated laparoscopically but remained constant at 62 ml/min per 1.73 m2 after OPN. Conclusions: Our data suggest that the surgical approach has a small effect on the recovery of renal function after partial nephrectomy. Laparoscopically treated patients maintained slightly higher renal function. © 2010 European Association of Urology.
Keywords: adult; middle aged; cancer surgery; surgical technique; recovery of function; major clinical study; laparoscopy; prospective studies; tumor volume; surgical approach; kidney neoplasms; nephrectomy; time factors; cancer center; partial nephrectomy; kidney tumor; ischemia; kidney function; operation duration; intermethod comparison; glomerular filtration rate; glomerulus filtration rate; multivariate analysis; laparoscopic partial nephrectomy; open partial nephrectomy; single sporadic tumor
Journal Title: European Urology
Volume: 58
Issue: 4
ISSN: 0302-2838
Publisher: Elsevier Science, Inc.  
Date Published: 2010-10-01
Start Page: 596
End Page: 601
Language: English
DOI: 10.1016/j.eururo.2010.05.044
PUBMED: 20554375
PROVIDER: scopus
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-77953313321&partnerID=40&md5=59842c0e2c8d14d72dee92271062a4d6
Notes: --- - "Export Date: 20 April 2011" - "CODEN: EUURA" - "Source: Scopus"
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MSK Authors
  1. Jonathan Coleman
    341 Coleman
  2. Caroline Savage
    80 Savage
  3. Paul Russo
    581 Russo
  4. Bertrand Guillonneau
    137 Guillonneau
  5. Lucas Mendes Nogueira
    31 Nogueira
  6. Karim Abdelkrim Touijer
    257 Touijer
  7. Ari Adamy Junior
    13 Adamy Junior
  8. Ricardo De Lima Favaretto
    14 De Lima Favaretto
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