Changes in Renal Function After Laparoscopic Partial Nephrectomy: Comparison With Laparoscopic Radical Nephrectomy
강수환, 류현열, 김택상,
소속 상세정보
강수환 ( Kang Su-Hwan )
Kosin University College of Medicine Kosin University Gospel Hospital Department of Urology
류현열 ( Rhew Hyun-Yul )
Kosin University College of Medicine Kosin University Gospel Hospital Department of Urology
김택상 ( Kim Taek-Sang )
Kosin University College of Medicine Kosin University Gospel Hospital Department of Urology
KMID : 0358320130540010022
Abstract
Purpose: To evaluate alterations in renal function after laparoscopic radical nephrectomy (LRN) and laparoscopic partial nephrectomy (LPN) for renal tumors.
Materials and Methods: From March 2008 to August 2011, we performed 175 cases of laparoscopic kidney resection. Among these, we excluded patients who received perioperative immunotherapy or target therapy and also patients with a preoperative estimated glomerular filtration rate (eGFR) <60 mL/min. A total of 32 patients undergoing LPN and 92 patients undergoing LRN were enrolled. We retrospectively reviewed the changes in eGFR (by the modification of diet in renal disease method) at the following time points: preoperative, postoperative 1 week, and postoperative 1, 3, 6, and 12 months.
Results: The mean warm ischemia time of the LPN group was 22 minutes (range, 0 to 47 minutes). Mean eGFR values (mL/min/1.73 m2) during postoperative week 1 and 1, 3, 6, and 12 months were 70.8, 71.5, 76.7, 76.0, and 75.3 in the LPN group and 52.1, 50.6, 52.8, 53.4, and 52.4 in the LRN group, respectively. One year after the operation, 6.3% (2 patients) of LPN patients and 68.5% (63 patients) of LRN patients had progressed to chronic renal insufficiency (eGFR<60 mL/min/1.73 m2).
Conclusions: Renal function recovered slightly after LPN and LRN and was maintained constantly after 3 months. However, renal function showed different patterns of decrease. Despite the concern for warm ischemia, LPN can preserve renal function better than can LRN. LPN should be considered for selected patients to prevent chronic renal insufficiency.
키워드
Chronic renal insufficiency;Laparoscopy;Nephrectomy
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