Recovery of renal function after open and laparoscopic partial nephrectomy. Academic Article uri icon

Overview

MeSH

  • Female
  • Glomerular Filtration Rate
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Time Factors

MeSH Major

  • Kidney Neoplasms
  • Laparoscopy
  • Nephrectomy
  • Recovery of Function

abstract

  • Although oncologic outcomes appear to be similar after laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN), data on renal function are lacking. To evaluate the change over time in renal function after LPN and OPN. 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. All patients underwent LPN or OPN at Memorial Sloan-Kettering Cancer Center. 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. 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 m(2) vs 73 ml/min per 1.73 m(2); 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 m(2) to 67 ml/min per 1.73 m(2), respectively, for those treated laparoscopically but remained constant at 62 ml/min per 1.73 m(2) after OPN. 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. Copyright 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.

publication date

  • October 2010

has subject area

  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney Neoplasms
  • Laparoscopy
  • Male
  • Middle Aged
  • Nephrectomy
  • Prospective Studies
  • Recovery of Function
  • Time Factors

Research

keywords

  • Journal Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1016/j.eururo.2010.05.044

PubMed ID

  • 20554375

Additional Document Info

start page

  • 596

end page

  • 601

volume

  • 58

number

  • 4