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Laparoscopic Partial Nephrectomy: Off-Clamp Versus on Clamp.

Malik Ayyad1, Omar Ayaad2, Hassan Alkhatatbeh3

  • 1Department of Urology Unit Special Surgery, Faculty of Medicine Mutah University Karak, Jordan.

Asian Pacific Journal of Cancer Prevention : APJCP
|May 28, 2022
PubMed
Summary
This summary is machine-generated.

Laparoscopic partial nephrectomy using the off-clamp technique resulted in greater blood loss and longer tumor resection times compared to the on-clamp method. However, the off-clamp approach may offer better kidney function outcomes.

Keywords:
JordanOff clampPartial Nephrectomylaparoscopic

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrology

Background:

  • Partial nephrectomy is a standard treatment for small renal masses.
  • Laparoscopic partial nephrectomy (LPN) offers advantages over open surgery.
  • The use of temporary renal artery clamping (on-clamp) versus no clamping (off-clamp) during LPN is debated.

Purpose of the Study:

  • To describe the authors' experience with LPN.
  • To compare clinical characteristics and outcomes of off-clamp versus on-clamp LPN.

Main Methods:

  • Retrospective study of 32 patients with small renal tumors (max diameter 3 cm, RENAL score ≥4).
  • Inclusion criteria focused on exophytic, solid or cystic, and suspected malignant tumors.
  • Data collected from patient files.

Main Results:

  • No significant differences in tumor size, kidney size, or tumor position between groups.
  • Off-clamp group had significantly higher expected blood loss (150.15 mL vs 75.25 mL, p<0.001).
  • No significant differences in complications, operation time, or renorrhaphy time.

Conclusions:

  • Off-clamp LPN was associated with longer tumor resection duration and increased blood loss.
  • Preliminary findings suggest potentially better estimated glomerular filtration rate outcomes with the off-clamp technique.
  • Further research is needed to confirm long-term safety and oncological efficacy of off-clamp LPN.