title: Evaluation of retroperitoneoscopic partial nephrectomy with in situ hypothermic perfusion.
abstract: BACKGROUND
  The objective of this study was to evaluate the clinical application value of in situ hypothermic perfusion of kidneys during retroperitoneal laparoscopic partial nephrectomy (RLPN).
  
  
  METHODS
  We used in situ hypothermic perfusion of kidneys during RLPN in 12 patients with renal tumour. Renal arterial-catheterisation for temporary balloon occlusion of renal artery was used Hypothermic ischaemia was achieved by continuous perfusion of Ringer's solution at 4°C through the renal artery.The collecting system was repaired by 4/0 Dixon and renal reconstruction was performed by 1/0 Dixon.We compared data between the RLPN group and open partial nephrectomy (OPN) group.
  
  
  RESULTS
  All RLPN operations were successfully completed. Ten of their pathological results were renal cell carcinoma, while two were reninoma and harmatoma respectively. Entry to the collecting system in two patients was repaired intraoperatively. No additional vascular repair was done. There were no significant postoperative complications. The renal function of the kidney was well preserved postoperatively. Neither local recurrence nor distant metastasis was found during the follow-up. There was a statistically significant difference in mean operative time and mean hypothermic ischaemia time between two groups. No difference was noted in mean tumour diameter, intraoperative blood loss, and preoperative and postoperative creatinine clearance rate.
  
  
  CONCLUSIONS
  The technique of incorporating hypothermic ischaemia via arterial perfusion into RLPN is feasible and safe, which expands the armamentarium of the urologist with the help of radiologists. It is of high clinical applied value, especially for the more complex nephron-sparing surgery.
authors.affiliation: Department of Urology, PeKing Union Medical College Hospital, Chinese Academy of Medical Sciences and PeKing Union, Medical College, Beijing 100730, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Wen
authors.forename: Han-Zhong
authors.initials: HZ
authors.lastname: Li
authors.forename: Zhi Gang
authors.initials: ZG
authors.lastname: Ji
authors.forename: Bing Bing
authors.initials: BB
authors.lastname: Shi
authors.forename: Wei Gang
authors.initials: WG
authors.lastname: Yan
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D002404:Catheterization; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007036:Hypothermia, Induced; D007511:Ischemia; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011300:Preoperative Care; D011379:Prognosis; D012077:Renal Artery; D012187:Retroperitoneal Space / Q000601:surgery*