[Comparative analysis about hemodynamic and renal blood flow effects during open versus laparoscopic nephrectomy. An experimental study].
BACKGROUND
The increase of intraabdominal pressure to 10 mmHg provokes a decrease of renal blood flow (RBF). Pneumoperitoneum during laparoscopic techniques with intra-abdominal pressure (IAP) to 15 mmHg, results in a decrease in RBF, urine output and glomerular filtration rate (GFR).


OBJECTIVE
Analyze the changes in RBF, urine output an GFR in a porcine experimental model during open vs laparoscopic nephrectomy.


METHODS
30 pigs (medium weigh= 22.6+3.2 Kg) were divided into two groups: Laparoscopic nephrectomy was performed using 15 pigs and open nephrectomy in 15 pigs, following a living donor nephrectomy autotransplantation model. Study parameters were urine volume and GFR baseline values, 30 and 60 minutes during nephrectomy. RBF was measured using an electromagnetic flow catheter around the main renal artery during the initial 60 minutes of nephrectomy.


RESULTS
The laparoscopic technique was associated with a significant reduction of RBF (80+2.7 vs 262+3 ml/min) (p<0.005), diuresis (42%) and GFR (38%), vs the open group.


CONCLUSIONS
Laparoscopic nephrectomy involves a significant reduction of RBF, GFR and diuresis, which is potentially transcendent in living donor nephrectomy and kidney transplantation.
Linares Quevedo
A I
AI
Servicio de Urología, Hospital de Fuenlabrada, Universidad de Alcalá, Madrid. analinaresquevedo@hotmail.com
Burgos Revilla
F J
FJ
Villafruela Sanz
J J
JJ
Romero Zamora
J
J
Pascual Santos
J
J
Marcén Letosa
R
R
Cuevas Sánchez
B
B
Correa Gorospe
C
C
D000818:Animals; D001794:Blood Pressure; D007668:Kidney / Q000098:blood supply*; D010535:Laparoscopy; D009392:Nephrectomy / Q000379:methods*; D012039:Regional Blood Flow; D013552:Swine