CANCUN, MEXICO (UroToday.com) - Coverage of the 25th Annual World Congress of Endourology and SWL - Cancun, Mexico - Friday, November 2^nd, 2007

This multi-institutional study examined the effects of ischemia on renal function in patients that had undergone renal extirpative or ablative surgery. Patients undergoing laparoscopic partial nephrectomy without warm ischemia, with warm ischemia, and with cold ischemia were compared to patients undergoing laparoscopic radical nephrectomy and laparoscopic cryoablation. Using the Cockroft-Gault equation, all patients undergoing a laparoscopic radical or partial nephrectomy under warm ischemia sustained a significant decrease in the creatinine clearance on post op day one compared to patients that had a laparoscopic partial nephrectomy without clamping or cryoablation. The decrease in the creatinine clearance correlated directly with the warm ischemia time. At six months, the decrease in creatinine clearance was no longer significant.

Of great interest was that patients with medical renal disease trended towards being more likely to sustain long term renal damage at 12 months post op. Future efforts therefore should be focused on eliminating warm ischemia or at a minimum allow for such procedures to be performed under cold ischemic conditions that are easily employed and adopted by all.

Session: Laparoscopy: Kidney: Partial Nephrectomy II
Moderators: Li-Ming Su (USA), Jihad H. Kaouk (USA)
Genoa Ferguson, Kelley V. Foyil, Caroline D. Ames, Kyle J. Weld, Robert S. Figenshau, Ramakrishna Venkatesh, Yan Yan, Ralph V. Clayman, Jaime Landman

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