Renal Cell Carcinoma
Conditions
Keywords
laparoscopic partial nephrectomy, precise segmental renal arterial clamping, renal cell carcinoma, renal functional reserve
Brief summary
Renal functional reserve may be better in patients with clinical T1 renal cell carcinoma(RCC) undergoing laparoscopic partial nephrectomy with precise segmental renal artery clamping than those with complete renal arterial clamping.
Detailed description
Renal functional reserve (RFR) describes the capacity of the intact nephron mass to increase glomerular filtration rate(GFR) from baseline in response to stimuli (e.g., protein load).We hypothesized that renal functional reserve may be better in patients with clinical T1 renal cell carcinoma(RCC) undergoing laparoscopic partial(LPN) nephrectomy with precise segmental renal artery clamping than those with complete renal arterial clamping.
Interventions
PROCEDUREprecise segmental renal arterial clamping
Precise segmental renal artery clamping eliminates global renal ischemia by performing highly selective clamping of single or multiple segmental arteries.
PROCEDURElaparoscopic partial nephrectomy
Laparoscopic partial nephrectomy (LPN) has been widely adopted as a minimally invasive nephron-sparing surgery for clinical T1 renal cell carcinoma(RCC).
Sponsors
Xuanwu Hospital, Beijing
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Some participants with clinical T1 renal cell carcinoma(RCC) undergo precise segmental during laparoscopic partial nephrectomy and the others undergo complete renal arterial clamping.
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* 1.Age ≥18 2.Estimated GFR \>30 mL/min/1.73m2 3.Anticipated intraoperative warm ischemic time ≤30 min 4.Subjects who signed informed consent forms
Exclusion criteria
1. Allergy to iothalamate, shellfish or iodine 2. Use of metformin or amiodarone 3. intraoperative warm ischemic time \>30 min 4. Inability to maintain a stable regimen of medications which affect GFR for \> one week prior to participation (e.g. non-steroidal anti-inflammatory drugs, angiotensin converting enzyme inhibitors, angiotensin receptor blockers) 5. Use of medications which directly affect elimination of creatinine (e.g. cimetidine and trimethoprim) 6. Acute exacerbation of asthma or chronic obstructive pulmonary disease within 3 months requiring hospitalization or oral steroid therapy 7. Inadequate intravenous access 8. Severe anemia (Hct \<21%) 9. Acute kidney injury (rise in creatinine to ≥1.5 times the previous baseline or by ≥ 0.3 mg/dL on most recent labs prior to enrollment) 10. History of contrast-induced nephropathy 11. Hyperthyroidism 12. Pheochromocytoma 13. Sickle cell disease 14. Urinary retention or incontinence 15. Status post organ transplant 16. Pregnancy or active breast feeding 17. Cognitive impairment with inability to give consent 18. Institutionalized status
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Renal Functional Reserve change | 3 month after surgery. | Change in renal functional reserve after laparoscopic partial nephrectomy |
Countries
China
Contacts
Primary ContactZhenhua Shang, MD.
Backup ContactHao Yan
Outcome results
None listed