Journal article
Comparison of Tissue Oxygenation Profiles Using 3 Different Methods of Vascular Control During Porcine Partial Nephrectomy
Urology (Ridgewood, N.J.), Vol.74(4), pp.926-931
2009
DOI: 10.1016/j.urology.2009.05.018
PMID: 19628267
Abstract
To compare oxygenation profiles and renal function outcomes between 3 methods of vascular control during porcine partial nephrectomy.
To create a solitary kidney model, 18 pigs were subjected to a laparoscopic nephrectomy. Following a 7-day recovery, a contralateral open partial nephrectomy was performed with vascular control by either total renal artery clamping (TRAC, n = 6), partial renal artery clamping (PRAC, n = 6), or selective renal parenchymal clamping (SRPC, n = 6). Renal partial oxygen pressure (rPO
2) was monitored using a Licox probe. Serum creatinine was assessed on day 0 and postoperative days 3 and 7. Pigs were sacrificed on the seventh day and the kidney sent for pathological examination.
Intraoperative oxygenation profiles demonstrated a lower percentage decline (
P = .01), longer interval to nadir (
P = .04), improved percentage recovery of baseline rPO
2 (
P = .04), and a shorter duration to recover baseline rPO
2 (
P = .03) in the PRAC and SRPC groups than in the TRAC. Despite not occluding the renal vasculature, the SRPC group experienced declines in rPO
2 profiles of almost 50% from baseline. Serum creatinine levels increased significantly more in the TRAC group at days 3 and 7 (
P = .04 and .01, respectively). Histological examination demonstrated patchy inflammation of parenchyma in all groups.
The rPO
2 monitoring may provide a novel means to allow real-time assessment and titration of kidney perfusion during partial nephrectomy. PRAC and SRPC demonstrate favorable renal oxygenation profiles compared with TRAC. Interestingly, SRPC kidneys experienced a significant decline in tissue oxygenation profiles. Further work is necessary to better delineate the mechanism underlying this decline.
Details
- Title: Subtitle
- Comparison of Tissue Oxygenation Profiles Using 3 Different Methods of Vascular Control During Porcine Partial Nephrectomy
- Creators
- Jay D Raman - Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PennsylvaniaKarim Bensalah - Department of Urology, University of Texas Southwestern Medical Center, Dallas, TexasAditya Bagrodia - Department of Urology, University of Texas Southwestern Medical Center, Dallas, TexasChad R Tracy - Department of Urology, University of Texas Southwestern Medical Center, Dallas, TexasWareef Kabbani - Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TexasArthur I Sagalowsky - Department of Urology, University of Texas Southwestern Medical Center, Dallas, TexasJeffrey A Cadeddu - Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas
- Resource Type
- Journal article
- Publication Details
- Urology (Ridgewood, N.J.), Vol.74(4), pp.926-931
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.urology.2009.05.018
- PMID
- 19628267
- ISSN
- 0090-4295
- eISSN
- 1527-9995
- Language
- English
- Date published
- 2009
- Academic Unit
- Radiology; Urology
- Record Identifier
- 9984051706102771
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