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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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Renal functional outcome after laparoscopic partial nephrectomy using dynamic renal scintigraphy.

Tetsuo Fujita1, Morihiro Nishi, Daisuke Ishii

  • 1Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan.

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|October 13, 2020
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Laparoscopic partial nephrectomy (LPN) can lead to decreased kidney function on the operated side. Prolonged warm ischemia time during LPN is a key factor impacting this renal functional outcome.

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Area of Science:

  • Urology
  • Nephrology
  • Surgical Outcomes

Background:

  • Laparoscopic partial nephrectomy (LPN) is a standard treatment for localized renal tumors.
  • Assessing postoperative renal function is crucial for patient management.

Purpose of the Study:

  • To evaluate the long-term renal functional outcome of the operated kidney after LPN.
  • To identify factors influencing postoperative renal function following LPN.

Main Methods:

  • Dynamic renal scintigraphy with technetium-99m-mercaptoacetyltriglycine was used to assess split renal function.
  • 62 patients undergoing ischemic LPN were evaluated preoperatively and at 6 and 12 months postoperatively.
  • Regression analyses were performed to identify predictive factors for renal function decrease.

Main Results:

  • Operation-side renal function significantly decreased at 6 and 12 months post-LPN (p < 0.0001).
  • Prolonged warm ischemia time was associated with decreased renal function at both 6 and 12 months.
  • Warm ischemia time emerged as an independent predictor of reduced renal function post-LPN.

Conclusions:

  • Dynamic renal scintigraphy reveals irreversible renal damage after LPN.
  • Minimizing warm ischemia time during LPN is essential to preserve postoperative renal function.