Premium
Impact of preoperative calculation of nephron volume loss on future of partial nephrectomy techniques; planning a strategic roadmap for improving functional preservation and securing oncological safety
Author(s) -
Rha Koon H.,
Abdel Raheem Ali,
Park Sung Y.,
Kim Kwang H.,
Kim Hyung J.,
Koo Kyo C.,
Choi Young D.,
Jung Byung H.,
Lee Sang K.,
Lee Won K.,
Krishnan Jayram,
Shin Tae Y.,
Cho JinSeon
Publication year - 2017
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13937
Subject(s) - nephrectomy , renal function , medicine , urology , linear regression , retrospective cohort study , surgery , kidney , mathematics , statistics
Objectives To assess the correlation of the resected and ischaemic volume ( RAIV ), which is a preoperatively calculated volume of nephron loss, with the amount of postoperative renal function ( PRF ) decline after minimally invasive partial nephrectomy ( PN ) in a multi‐institutional dataset. Patients and Methods We identified 348 patients from March 2005 to December 2013 at six institutions. Data on all cases of laparoscopic ( n = 85) and robot‐assisted PN ( n = 263) performed were retrospectively gathered. Univariable and multivariable linear regression analyses were used to identify the associations between various time points of PRF and the RAIV , as a continuous variable. Results The mean ( sd ) RAIV was 24.2 (29.2) cm 3 . The mean preoperative estimated glomerular filtration rate ( eGFR ) and the eGFR s at postoperative day 1, 6 and 36 months after PN were 91.0 and 76.8, 80.2 and 87.7 mL /min/1.73 m 2 , respectively. In multivariable linear regression analysis, the amount of decline in PRF at follow‐up was significantly correlated with the RAIV (β 0.261, 0.165, 0.260 at postoperative day 1, 6 and 36 months after PN , respectively). This study has the limitation of its retrospective nature. Conclusion Preoperatively calculated RAIV significantly correlates with the amount of decline in PRF during long‐term follow‐up. The RAIV could lead our research to the level of prediction of the amount of PRF decline after PN and thus would be appropriate for assessing the technical advantages of emerging techniques.