A comparison of cooling methods for laparoscopic partial nephrectomy.
OBJECTIVE
To evaluate appropriate cooling methods in laparoscopic partial nephrectomy.


METHODS
Under general anesthesia, 21 porcine kidneys were exposed retroperitoneoscopically. Ice slush (500 g) was put into the retroperitoneal cavity after renal vascular clamping. Renal parenchymal temperature was measured by a thermometer. Seven kidneys were cooled only by ice slush (group I). In seven kidneys, 200 mL of 4 degrees C saline was infused around the kidney 45 minutes after vascular clamping (group II). In seven kidneys, 4 degrees C saline was irrigated continuously through a 5F ureteral catheter, which was inserted into the ureter (group III).


RESULTS
In group I, 21 minutes after vascular clamping, the lowest temperature achieved was 13.2 degrees C, and at 47 minutes the temperature exceeded 20 degrees C. In group II, the lowest temperature achieved was 13.0 degrees C 23 minutes after vascular clamping, and at 59 minutes the temperature exceeded 20 degrees C. In group III, the lowest temperature of 10.6 degrees C was achieved at 27 minutes, and at 79 minutes the temperature exceeded 20 degrees C.


CONCLUSIONS
In complicated cases of laparoscopic partial nephrectomy, cooling with both ice slush and ureteral catheter irrigation was thought to be effective. When the renal collecting system is opened, an additional infusion of cooled water may also be effective.
Naya
Yoshio
Y
Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Kawauchi
Akihiro
A
Yoneda
Kimihiko
K
Ushijima
So
S
Naitoh
Yasuyuki
Y
Soh
Jintetsu
J
Ito
Yoshizo
Y
Mizutani
Yoichi
Y
Miki
Tsuneharu
T
D000818:Animals; D003080:Cold Temperature; D007053:Ice; D007668:Kidney / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D009392:Nephrectomy / Q000379:methods*; D013514:Surgical Procedures, Operative / Q000379:methods; D013552:Swine; D013696:Temperature; D016896:Treatment Outcome; D014546:Urinary Catheterization
D007053:Ice