Efficacy of parenchymal compression in open partial nephrectomies: a comparison with conventional vascular clamping.
OBJECTIVE
We evaluated the efficacy of parenchymal compression in open partial nephrectomies (OPNs) compared with that of the conventional vascular clamping method.


METHODS
OPNs were conducted by means of the parenchymal compression technique at our institution from April 2006. Among these, the operative outcomes of 20 consecutive patients with normal preoperative renal function (Group 1) were matched with those of 20 control patients from the database of previous operations who underwent OPN with a conventional vascular clamping method (Group 2).


RESULTS
All preoperative characteristics were similar in both groups. The operative time was significantly higher for Group 2 (132.4+/-17.7 vs. 151.4+/-21.4 minutes, p=0.031). Estimated blood loss was slightly higher for Group 2, with marginal statistical significance (173.7+/-11.5 vs. 211.2+/-43.8 ml, p=0.06). Histologic examination revealed that over 80% of the tumors in both groups were renal cell carcinomas. For all patients, the pathology results of specimens were negative. Serum creatinine, checked at 1, 3, and 7 days after the operation, was significantly increased in both groups to a similar degree. However, 30 days after surgery, the patterns of serial serum creatinine levels demonstrated statistically significant differences by repeated-measures ANOVA (p<0.001), with a trend of more elevated in Group 2 than in Group 1, although values were within the normal range. No major complications occurred in either group.


CONCLUSIONS
OPN using the parenchymal compression method had acceptable outcomes in terms of complete tumor control, avoiding warm ischemic time, and minimizing blooding, with good preservation of renal function and minimal complications.
Ko
Young Hwii
YH
Department of Urology, Korea University School of Medicine, Seoul, Korea.
Choi
Hoon
H
Kang
Sung Gu
SG
Kang
Seok Ho
SH
Park
Hong Seok
HS
Cheon
Jun
J
Lee
Jeong Gu
JG
Kim
Je Jong
JJ
Yoon
Duck Ki
DK