Influence of robot-assisted partial nephrectomy on long-term renal function as assessed using DTPA renal scintigraphy
Influence of robot-assisted partial nephrectomy on long-term renal function as assessed using DTPA renal scintigraphy
复制标题
使用 DTPA 肾闪烁扫描评估机器人辅助肾部分切除术对长期肾功能的影响
DOI：
10.1089/end.2021.0243
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发表时间：
2021
影响因子：
2.7
通讯作者：
Obara Wataru
中科院分区：
文献类型：
--
作者：
Matsuura Tomohiko;Ito Ayato;Moriguchi Mariko;Ikarashi Daiki;Tamura Daichi;Kato Renpei;Maekawa Shigekatsu;Kato Yoichiro;Kanehira Mitsugu;Takata Ryo;Sugimura Jun;Abe Takaya;Obara Wataru
背景：机器人辅助肾部分切除术（RAPN）后的长期肾功能分裂尚未阐明。本研究旨在使用肾闪烁扫描技术评估 RAPN 的长期肾功能，并确定与患侧肾脏肾功能恶化相关的临床因素。 患者和方法：对小肿瘤进行 RAPN，并在术前和术后 1 年使用 99m-Tc DTPA 肾闪烁扫描技术评估裂体肾功能。临床因素（年龄、性别、体重指数、肿瘤部位、是否存在尿蛋白、糖尿病、高血压和血脂异常）、围手术期因素（肾切除评分[RNS]、肿瘤直径、总手术时间、控制台时间、热缺血时间和出血量）和肾功能（估计肾小球滤过率[eGFR]和 分析了使用闪烁扫描仪在受影响和对侧肾脏上测量的肾小球滤过率 [GFR]。结果：该研究纳入了 66 名患者。 1 年后，中位 eGFR 从 71.9 降至 63.9mL/min (p<0.001)，平均下降 10.1%。在闪烁扫描检查中，1年后受影响肾侧的中位 GFR 从 41.1 降至 33.7mL/min (p<0.001)，平均损失 16.8%。 RNS 与肾功能显着相关。 RNS因素中，N因素与RAPN术后肾功能相关。结论：RNS，特别是N因素，可能影响RAPN术后肾功能的长期恶化。
Background:The long-term split renal function after robot-assisted partial nephrectomy (RAPN) is yet to be elucidated. This study aimed to assess long-term renal function of RAPN, using renal scintigraphy, and to identify clinical factors related to deterioration of renal function on the affected side of the kidney.Patients and Methods:RAPN for small tumors was performed, and split renal function was evaluated using 99m-Tc DTPA renal scintigraphy before and 1 year after surgery. Clinical factors (age, gender, body mass index, tumor side, presence of urinary protein, diabetes, hypertension, and dyslipidemia), perioperative factors (renal nephrectomy score [RNS], tumor diameter, overall surgery duration, console time, warm ischemic time, and amount of bleeding), and renal function (estimated glomerular filtration rate [eGFR] and glomerular filtration rate [GFR] measured using scintigraphy on both the affected and contralateral kidneys) were analyzed.Results:Sixty-six patients were included in the study. The median eGFR decreased from 71.9 to 63.9 mL/min after 1 year (p< 0.001), accounting for a mean loss of 10.1%. In scintigraphy examination, the median GFR on the affected kidney side decreased from 41.1 to 33.7 mL/min after 1 year (p< 0.001), accounting for a mean loss of 16.8%. RNS was significantly associated with renal function. Among RNS factors, the N factor is associated with renal function after RAPN.Conclusion:RNS, particularly the N factor, possibly influences the long-term deterioration of renal function after RAPN.