Two-year analysis for predicting renal function and contralateral hypertrophy after robot-assisted partial nephrectomy: A three-dimensional segmentation technology study
Objectives To analyze long‐term changes in both kidneys, and to predict renal function and contralateral hypertrophy after robot‐assisted partial nephrectomy. Methods A total of 62 patients underwent robot‐assisted partial nephrectomy, and renal parenchymal volume was calculated using three‐dimensio...
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Published in | International journal of urology Vol. 22; no. 12; pp. 1105 - 1111 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Australia
Blackwell Publishing Ltd
01.12.2015
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Subjects | |
Online Access | Get full text |
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Summary: | Objectives
To analyze long‐term changes in both kidneys, and to predict renal function and contralateral hypertrophy after robot‐assisted partial nephrectomy.
Methods
A total of 62 patients underwent robot‐assisted partial nephrectomy, and renal parenchymal volume was calculated using three‐dimensional semi‐automatic segmentation technology. Patients were evaluated within 1 month preoperatively, and postoperatively at 6 months, 1 year and continued up to 2‐year follow up. Linear regression models were used to identify the factors predicting variables that correlated with estimated glomerular filtration rate changes and contralateral hypertrophy 2 years after robot‐assisted partial nephrectomy.
Results
The median global estimated glomerular filtration rate changes were −10.4%, −11.9%, and −2.4% at 6 months, 1 and 2 years post‐robot‐assisted partial nephrectomy, respectively. The ipsilateral kidney median parenchymal volume changes were −24%, −24.4%, and −21% at 6 months, 1 and 2 years post‐robot‐assisted partial nephrectomy, respectively. The contralateral renal volume changes were 2.3%, 9.6% and 12.9%, respectively. On multivariable linear analysis, preoperative estimated glomerular filtration rate was the best predictive factor for global estimated glomerular filtration rate change on 2 years post‐robot‐assisted partial nephrectomy (B −0.452; 95% confidence interval −0.84 to −0.14; P = 0.021), whereas the parenchymal volume loss rate (B −0.43; 95% confidence interval −0.89 to −0.15; P = 0.017) and tumor size (B 5.154; 95% confidence interval −0.11 to 9.98; P = 0.041) were the significant predictive factors for the degree of contralateral renal hypertrophy on 2 years post‐robot‐assisted partial nephrectomy.
Conclusions
Preoperative estimated glomerular filtration rate significantly affects post‐robot‐assisted partial nephrectomy renal function. Renal mass size and renal parenchyma volume loss correlates with compensatory hypertrophy of the contralateral kidney. Contralateral hypertrophy of the renal parenchyma compensates for the functional loss of the ipsilateral kidney. |
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Bibliography: | ark:/67375/WNG-T5G7RLMM-M ArticleID:IJU12913 istex:14F2D735F42F240B2F1CDF1E368AF30C3C4F976B ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0919-8172 1442-2042 |
DOI: | 10.1111/iju.12913 |