Abstract：
:Partial nephrectomy has become an accepted treatment of cT1 renal masses as it provides improved long-term renal function compared to radical nephrectomy (Campbell et al. J Urol. 182:1271-9, 2009). Hilar clamping is utilized to help reduce bleeding and improve visibility during tumor resection. However, concern over risk of kidney injury with hilar clamping has led to new techniques to reduce length of warm ischemia time (WIT) during partial nephrectomy. These techniques have progressed over the years starting with early hilar unclamping, controlled hypotension during tumor resection, selective arterial clamping, minimal margin techniques, and off-clamp procedures. Selective arterial clamping has progressed significantly over the years. The main question is what are the exact short- and long-term renal effects from increasing clamp time. Moreover, does it make sense to perform these more time-consuming or more complex procedures if there is no long-term preservation of kidney function? More recent studies have shown no difference in renal function 6 months from surgery when selective arterial clamping or even hilar clamping is employed, although there is short-term improved decline in estimated glomerular filtration rate (eGFR) with selective clamping and off-clamp techniques (Komninos et al. BJU Int. 115:921-8, 2015; Shah et al. 117:293-9, 2015; Kallingal et al. BJU Int. doi: 10.1111/bju.13192, 2015). This paper reviews the progression of total hilar clamping to selective arterial clamping (SAC) and the possible difference its use makes on long-term renal function. SAC may be attempted based on surgeon's decision-making, but may be best used for more complex, larger, more central or hilar tumors and in patients who have renal insufficiency at baseline or a solitary kidney.
journal_name
Curr Urol Repjournal_title
Current urology reportsauthors
Yezdani M,Yu SJ,Lee DIdoi
10.1007/s11934-016-0596-0subject
Has Abstractpub_date
2016-05-01 00:00:00pages
40issue
5eissn
1527-2737issn
1534-6285pii
10.1007/s11934-016-0596-0journal_volume
17pub_type
杂志文章,评审abstract：:Preservation of postoperative urinary continence remains the primary concern of all men and their surgeons following robot-assisted radical prostatectomy (RARP). Without doubt, continence is the most important quality of life issue following radical prostatectomy. Identification of difficulties and lessons learned ove...
journal_title：Current urology reports
pub_type： 杂志文章,评审
doi：10.1007/s11934-012-0295-4
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journal_title：Current urology reports
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journal_title：Current urology reports
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journal_title：Current urology reports
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journal_title：Current urology reports
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更新日期：2013-08-01 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
doi：10.1007/s11934-014-0403-8
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journal_title：Current urology reports
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更新日期：2014-08-01 00:00:00
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journal_title：Current urology reports
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journal_title：Current urology reports
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journal_title：Current urology reports
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2011-12-01 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2017-01-01 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2016-11-01 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2000-08-01 00:00:00
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journal_title：Current urology reports
pub_type： 历史文章,杂志文章,评审
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更新日期：2019-01-30 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2010-07-01 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2017-05-01 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2005-02-01 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2017-03-01 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2010-09-01 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2004-10-01 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2009-01-01 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,评审
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更新日期：2018-07-09 00:00:00
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journal_title：Current urology reports
pub_type： 杂志文章,已发布勘误
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更新日期：2019-04-05 00:00:00
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journal_title：Current urology reports
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更新日期：2012-02-01 00:00:00
