title: Nephron-sparing surgery: the effect of surface cooling and temporary renal artery occlusion on renal function.
abstract: OBJECTIVE
  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 (99m)Tc-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 (99m)Tc-DMSA-SPECT were compared preoperatively and in the 3rd postoperative month. (99m)Tc-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).
  
  
  CONCLUSIONS
  Renal artery clamping and external cooling during nephron-sparing surgery have no demonstrable harmful effects on the renal parenchyma as measured by (99m)Tc-DMSA-SPECT analysis.
authors.affiliation: Urology Clinic, Diskapi Yildirim Beyazit Research and Training Hospital, Ankara, Turkey. hasanbakirtas@hotmail.com
authors.forename: Hasan
authors.initials: H
authors.lastname: Bakirtas
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Eroglu
authors.forename: Seniha
authors.initials: S
authors.lastname: Naldoken
authors.forename: Ziya
authors.initials: Z
authors.lastname: Akbulut
authors.forename: U Yener
authors.initials: UY
authors.lastname: Tekdogan
mesh_terms: D000328:Adult; D000368:Aged; D003250:Constriction; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012077:Renal Artery / Q000601:surgery*; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D003404:Creatinine