Munich, Germany (UroToday.com) Dr. Volkova presented on the surgical outcomes of partial nephrectomy patients with and without renal artery clamp.
The group analyzed 468 consecutive patients who underwent partial nephrectomy for cT1-T3aN0M0 RCC. Median age was 54.8 (range 22-81). Bilateral lesions were in 141 (30.1%) cases. 95 (20.3%) patients had solitary kidney. Median RENAL score was 5.6 (4-11). 41 (8.8%) of tumors were high complexity RENAL score. 111 (23.8%) underwent partial nephrectomy without renal artery clamping while 357 (76.2%) had renal artery clamping with median ischemia time of 26 (range 5-60) min. Median follow up was 71.9 (10-265.1) months.
Patients with and without renal artery clamping were well balanced to demographic, nephrometric and renal function variables. Renal artery clamping reduced postoperative complication rates (5% vs 10.8%, p = 0.023). There was no difference in intraoperative blood loss, intraoperative complication rates, surgical margins, 5-year recurrence free survival, and 5-year cancer specific survival. In patients with high complexity RENAL score, renal artery clamping was associated with reduction in EBL. Additionally, in solitary kidney, zero ischemia reduced the rate of acute dialysis (0% vs 4.7%).
The group concludes that renal artery clamping is a safe procedure particularly in high-risk RENAL index tumors. Zero ischemia may however be used in patients with solitary kidney.
Presented By: Volkova M., Matveev V., Figurin K., Chernyaev V., Klimov A.
Reported By: Mohammed Haseebuddin, MD, at the 31st Annual EAU Congress - March 12 - 15, 2016 – Munich, Germany Fox Chase Cancer Center