A review and systematic analysis by BMC Nephrology indicates that, in cases of small renal tumors, partial nephrectomy performed without clamping the renal blood vessels. Rather than with clamping—better preserves kidney function after surgery.
A pooled analysis of data from 25 cohort studies showed that patients who underwent surgery without clamping were less likely to have an estimated glomerular filtration rate (eGFR) below 48 mL/min/1.73m². Three months after the operation, compared to those who had surgery with clamping — according to Dr. Bin Fu from the clinical department of Nanchang University in China.
Additionally, patients who underwent surgery with clamping experienced a greater increase in serum creatinine levels compared to those who had surgery without clamping.
Key Findings:
- Six months or more after surgery, distant changes and the percentage change in estimated glomerular filtration rate (eGFR) were higher in the case of partial nephrectomy performed with clamping.
- The researchers also report a 27% reduction in the risk of developing acute kidney failure in the group that underwent surgery without clamping.
- Performing surgery without clamping leads to less renal ischemia and trauma.
- The risk of developing chronic kidney failure is 75% lower in the no-clamping group.
The results of the study may vary depending on the surgeon’s experience and the distribution of patients for treatment.
The analysis did not include randomized controlled trials, so the research team recommends conducting a high-quality study on this topic in the future.
“Several documents have compared these two surgical procedures, but none of the articles addressed their long-term impact on kidney function. This topic is particularly important for the effective selection of the method when possible,” note Dr. Fu and his team. “In younger patients, there are increasingly more cases of peripheral kidney cancer diagnosed as T1-T2a, and improving the outcome is crucial.”
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