Partial Nephrectomy, Renal Cell Carcinoma
Conditions
Keywords
partial nephrectomy, hypoperfusion, renal function
Brief summary
Many patients who are candidates for nephron-sparing surgery, partial nephrectomy is now the standard treatment with a surgical, small, clinical T1 tumor (\<7 cm). In many recent studies, partial nephrectomy provides equivalent oncologic, and superior functional, outcomes compared with the standard radical nephrectomy over the short and long term (2, 3). Partial nephrectomy techniques, whether open, laparoscopic or robotic, typically involve hilar clamping, which creates the desired bloodless operative field, allowing for more precise tumor excision and renal reconstruction. This hilar clamping eventually may lead to ischemic kidney injury which can compromise the functional outcomes of the remaining kidney.We are working now to develop a novel technique of Hypo-Perfusion by achieving partial renal arterial clamping, with the goal of completely eliminating surgical ischemia to the renal remnant.
Interventions
PROCEDUREHypoperfusion of renal artery
The renal artery is occluded to 30% of it's baseline, prior to kidney tumour removal
Sponsors
University Health Network, Toronto
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Patient must be at least 18 years old scheduled for open partial nephrectomy
Exclusion criteria
* No prior diagnosis of renal artery disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To perfect the Renal Hypoperfusion during partial nephrectomy is feasible safe and result in better renal function than complete occlusion of renal blood flow | up to 2 weeks prior to surgery and up to 24 hrs post surgery | renal function will be measured using creatinine, eGFR, 24 hr creat clearance, and NGAL biomarker of acute kidney injury |
Countries
Canada
Outcome results
None listed