Comparison of off-clamp microwave scissors-based sutureless partial nephrectomy versus on-clamp conventional partial nephrectomy in a canine model

Frontiers in Surgery

Surgery

Tohru Tani¹  Shigeyuki Naka²  Ha Ngoc Nguyen³  Ken-Ichi Mukaisho⁴  Atsushi Yamada⁵ 

[1] Department of Advanced Medical Research and Development, Shiga University of Medical Science, Shiga, Japan;Department of Advanced Medical Research and Development, Shiga University of Medical Science, Shiga, Japan;Department of Surgery, Hino Memorial Hospital, Shiga, Japan;Department of Advanced Medical Research and Development, Shiga University of Medical Science, Shiga, Japan;Department of Urology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam;Division of Pathology, Shiga University of Medical Science, Shiga, Japan;Medical Innovation Research Center, Shiga University of Medical Science, Shiga, Japan;

关键词: partial nephrectomy;    off-clamp;    microwaves;    renal function;    renal ischemia;   

DOI  :  10.3389/fsurg.2023.1255929

 received in 2023-07-10, accepted in 2023-09-05,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesTo compare the usefulness and safety of off-clamp microwave scissors-based sutureless partial nephrectomy (MSPN) with on-clamp conventional partial nephrectomy (cPN) in dogs.MethodsWe performed off-clamp MSPN using microwave scissors (MWS) in six dogs, and on-clamp cPN in three dogs, in two-stage experiments. The bilateral kidney upper poles were resected via a midline incision under general anesthesia. After 14 days of follow-up, the lower pole resections were performed. The renal calyces exposed during renal resections were sealed and transected using MWS in off-clamp MSPN and were sutured in on-clamp cPN. In the off-clamp MSPN group, the generator's power output of MWS was set as either 50 W or 60 W for each kidney side. We compared the procedure time (PT), ischemic time (IT), blood loss (BL), and normal nephron loss (NNL) between the two techniques using the Mann–Whitney U-test.ResultsWe successfully performed 24 off-clamp MSPNs and 12 on-clamp cPNs. The off-clamp MSPN was significantly superior to on-clamp cPN in avoiding renal ischemia (median IT, 0 min vs. 8.6 min, p < 0.001) and reducing PT (median PT, 5.8 min vs. 11.5 min, p < 0.001) and NNL (median NNL, 5.3 mm vs. 6.0 mm, p = 0.006) with comparable BL (median BL, 20.9 ml vs. 23.2 ml, p = 0.804). No bleeding and major urine leakage were noted during the reoperations.ConclusionsOff-clamp MSPN outperforms on-clamp cPN in lowering the risks of postoperative renal function impairment in dogs.

【 授权许可】

Unknown   
© 2023 Nguyen, Yamada, Naka, Mukaisho and Tani.