Assessment of the kidney functional state prior and after partial nephrectomy for a unilateral tumor using mathematical processing of computed tomography data with contrast enhancement-Reference-Cited by-同舟云学术

Assessment of the kidney functional state prior and after partial nephrectomy for a unilateral tumor using mathematical processing of computed tomography data with contrast enhancement

Published:2023-09-11 Issue:3 Volume:24 Page:66-74
ISSN:2412-8902
Container-title:Andrology and Genital Surgery
language:
Short-container-title:Androl. genit. hir.

Author:

Proskura A. V.¹^ORCID,Alyaev Yu. G.²^ORCID,Borisov V. V.³,Butnaru D. V.²^ORCID,Rapoport L. M.²^ORCID,Sirota E. S.⁴^ORCID,Suvorov A. Yu.⁵^ORCID,Fiev D. N.⁶^ORCID,Shpot E. V.¹^ORCID,Bezrukov E. A.¹^ORCID,Enikeev M. E.¹^ORCID,Akopyan G. N.²^ORCID,Korolev D. O.²^ORCID,Vorobiev A. A.²,Chernenkiy M. M.⁴^ORCID,Chernenkiy I. M.⁴^ORCID,Ismailov Kh. M.²^ORCID,Shomukimova Z. S.²^ORCID

Affiliation:

1. Institute of Urology and Human Reproductive Health, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); University Clinical Hospital No. 2 of the I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

2. Institute of Urology and Human Reproductive Health, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

3. Russian Association of Urology

4. Center for Neural Network Technologies of the Research Institute of Uronephrology and Human Reproductive Health, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

5. Center for Analysis of Complex Systems of the Institute of Biodesign and Modeling of Complex Systems, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

6. Institute of Urology and Human Reproductive Health, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); University Clinical Hospital No. 2 of the I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Center for Neural Network Technologies of the Research Institute of Uronephrology and Human Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University)

Abstract

Background. According to the contemporary data available contrast-enhanced computed tomography can be used to assess total and split kidney function. The Urology Clinic of the I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University) utilizes mathematical processing of computed tomography data for the assessment of split kidney function.Aim. To evaluate the effect of main renal artery clamping (warm ischemia time) during partial nephrectomy for a unilateral tumor on the kidney function.Materials and methods. 33 patients of both sexes who underwent partial nephrectomy for unilateral kidney tumor were enrolled in the study. Prior to and 3–6 months after the surgery, 3D glomerular filtration rate (GFR), 3D perfusion, 3D volume of the renal parenchyma were evaluated by mathematical processing of computed tomography data with contrast enhancement. As well as that the dynamics of the total GFR (CKD-EPI equation) and total volume of the kidneys were assessed.Results. No significant changes were registered for both general functional renal parameters (creatinine level, total GFR, total volume of functioning renal parenchyma) and split 3D GFR. There were significant differences in 3D perfusion and kidney parenchyma volume prior and after partial nephrectomy.Conclusion. The results of the research highlight good reserve capacity the kidneys after partial nephrectomy with main renal artery clamping. The evidence that the non-operated kidney takes over the function of the resected kidney is based on the fact that there is an increase in its perfusion and volume of the kidney in the postoperative period. This state can also be regarded as a redistribution of functional loads between the kidneys, which is an adaptive mechanism in the postoperative period.

Publisher

Publishing House ABV Press

Subject

Urology,Reproductive Medicine,Surgery

Reference47 articles.

1. Campbell S.C., Novick A.C., Belldegrun A. et al. Guideline for management of the clinical T1 renal mass. J Urol 2009;182(4):1271–9. DOI: 10.1016/j.juro.2009.07.004

2. Ljungberg B., Bensalah K., Canfield S. et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol 2015;67(5):913–24. DOI: 10.1016/j.eururo.2015.01.005

3. MacLennan S., Imamura M., Lapitan M.C. et al. Systematic review of perioperative and quality-of-life outcomes following surgical management of localised renal cancer. Eur Urol 2012;62(6):1097–117. DOI: 10.1016/j.eururo.2012.07.028

4. Liss M.A., Wang S., Palazzi K. et al. Evaluation of national trends in the utilization of partial nephrectomy in relation to the publication of the American Urologic Association guidelines for the management of clinical T1 renal masses. BMC Urol 2014;14:101. DOI: 10.1186/1471-2490-14-101

5. Fergany A.F., Hafez K.S., Novick A.C. Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urol 2000;163(2):442–5. PMID: 10647650.