Aims: To evaluate whether transient renal artery clamping and external renal hypothermia cause any detrimental effect on the remaining renal parenchyma after nephron-sparing surgery with the use of 99mTc-DMSA-SPECT. Methods: Twenty-eight patients with a unilateral renal mass but a normal contralateral kidney underwent nephron-sparing surgery. Serum biochemistry, 24-hour urinary creatinine clearance and absolute uptakes of the injected dose (%ID) of both kidneys as measured by renal 99mTc-DMSA-SPECT were compared preoperatively and in the 3rd postoperative month. 99mTc-DMSA uptakes in the contralateral kidney were used as controls. Results: The average tumor size and mean renal artery clamping time were 37.4 ± 11.3 (range 25–68) mm and 53.7 ± 13 (range 38–90) min, respectively. Pre- and postoperative mean absolute uptakes of %ID in the remaining parenchyma of the operated kidneys were 15.13 ± 3.30 and 14.74 ± 3.38%, respectively (p = 0.052). In the contralateral kidneys, there was also no significant difference between the two studies (18.82 ± 6.26 vs. 19.14 ± 7.19%, respectively; p = 0.546). Likewise, there was no statistically significant difference between pre- and postoperative serum creatinine (p = 0.179) and creatinine clearance values (p = 0.108). Conclusion: Renal artery clamping and external cooling during nephron-sparing surgery have no demonstrable harmful effects on the renal parenchyma as measured by 99mTc-DMSA-SPECT analysis.

Keywords:
Kidney neoplasms, Nephrectomy, partial, Hypothermia, Radionuclide imaging, 99mTc-DMSA-SPECT, Ischemia
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© 2009 S. Karger AG, Basel
2009
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