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Impact of preoperative calculation of nephron volume loss on future of partial nephrectomy techniques; planning a strategic roadmap for improving functional preservation and securing oncological safety

 Koon H. Rha  ;  Ali Abdel Raheem  ;  Sung Y. Park  ;  Kwang H. Kim  ;  Hyung J. Kim  ;  Kyo C. Koo  ;  Young D. Choi  ;  Byung H. Jung  ;  Sang K. Lee  ;  Won K. Lee  ;  Jayram Krishnan  ;  Tae Y. Shin , Jin?Seon Cho , 
 BJU International, Vol.120(5) : 682-688, 2017 
Journal Title
 BJU International 
Issue Date
OBJECTIVES: To assess the correlation of the resected and ischaemic volume (RAIV), which is a preoperatively calculated volume of nephron loss, with the amount of postoperative renal function (PRF) decline after minimally invasive partial nephrectomy (PN) in a multi-institutional dataset. PATIENTS AND METHODS: We identified 348 patients from March 2005 to December 2013 at six institutions. Data on all cases of laparoscopic (n = 85) and robot-assisted PN (n = 263) performed were retrospectively gathered. Univariable and multivariable linear regression analyses were used to identify the associations between various time points of PRF and the RAIV, as a continuous variable. RESULTS: The mean (sd) RAIV was 24.2 (29.2) cm3 . The mean preoperative estimated glomerular filtration rate (eGFR) and the eGFRs at postoperative day 1, 6 and 36 months after PN were 91.0 and 76.8, 80.2 and 87.7 mL/min/1.73 m2 , respectively. In multivariable linear regression analysis, the amount of decline in PRF at follow-up was significantly correlated with the RAIV (β 0.261, 0.165, 0.260 at postoperative day 1, 6 and 36 months after PN, respectively). This study has the limitation of its retrospective nature. CONCLUSION: Preoperatively calculated RAIV significantly correlates with the amount of decline in PRF during long-term follow-up. The RAIV could lead our research to the level of prediction of the amount of PRF decline after PN and thus would be appropriate for assessing the technical advantages of emerging techniques.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
구교철(Koo, Kyo Chul) ORCID logo https://orcid.org/0000-0001-7303-6256
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
알리압델(Raheem, Ali Abdel)
정병하(Chung, Byung Ha) ORCID logo https://orcid.org/0000-0001-9817-3660
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
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