A comparison of renal functional outcomes after partial nephrectomy with and without pedicle clamping

Abstract

Introduction: Considering the mixed results reported about partial nephrectomy with and without pedicle clamping, this study aimed to compare the impacts of these two techniques on renal functional outcome. Materials and methods: this descriptive analytical study was conducted on 40 patients with renal cancer who underwent partial nephrectomy. They were randomly assigned to pedicle clamping (20 patients) and non-clamping groups(20 patients). The day before surgery, the routine tests as well as DTPA scan were carried out and some questions were asked from them; during the surgery, the amount of blood loss and the duration of pedicle clamping were measured; and after the surgery, the needed tests were performed for all of the patients. Also, 3 months after being discharged from the hospital, DTPA scan was carried out for all of the patients once again. Finally, the obtained data were all fed into SPSS v18 and the needed statistical analyses were performed. Results: The levels of operative blood loss(P=0.000) and blood transfusion(P=0.001) in non-pedicle clamping group were higher than other group. The mean duration of surgery in the clamping group was 139.2 minutes and non-pedicle group 149 minutes (P=0.258). The results of renal scans 3 months after the surgery indicated that the level of renal function decline in the pedicle clamping group was significantly higher than that in the non-pedicle clamping group(P=0.000). Conclusion: The results of this study indicated that partial nephrectomy without pedicle clamping can lead to a better renal function in the short run.

Keywords: partial nephrectomy, pedicle clamping, kidney cancer