Decrease of Renal Function due to Warm Ischemia after Laparoscopic Partial Nephrectomy: Evaluation Using 99mTc-DMSA Renal Scintigraphy

Introduction: The purpose of this study is, using technetium-99m-dimercaptosuccinic acid (Tc-99m-DMSA), to evaluate the decrease of renal function caused by warm ischemia. Patients and Methods: The Tc-99m-DMSA scan was performed before and 1, 3 and 6 months after the operation for 19 consecutive patients. The patients were divided into three groups by warm ischemic time (group A: <= 40 min, B: > 40 min boolean AND <= 60 min, C: > 60 min). Renal function of the unresected part was defined as the uptake to unresected part relative to the uptake to the contralateral kidney. The reduction of renal function was expressed as a ratio of the function after the surgery divided by function before the surgery and was compared between the three groups. Results: The reduction in group C after 1 and 3 months tended to be greater than that in group A or B, although not reaching statistical significance (one-way ANOVA test, 1 month: p = 0.15 and 3 months: p = 0.13). There was a significant difference in reduction of renal function between the three groups after 6 months (one-way ANOVA test, p = 0.02). The Scheffe test showed a statistical significance between groups A and C (p < 0.05). Conclusion: Renal function calculated by Tc-99m-DMSA shows that prolonged ischemic time causes significant damage to the kidney. Copyright (C) 2009 S. Karger AG, Basel