Does Robot-Assisted Radical Prostatectomy Affect Renal Intravascular Parameters and Glomerular Filtration Rate?

We aimed to investigate the effects of intra-abdominal pressure and steep Trendelenburg position on the intrarenal vascular parameters and estimated glomerular filtration rate (eGFR) in the first 24 hours of robot-assisted radical prostatectomy (RARP) surgery.

We prospectively studied 31 men who underwent RARP for prostate cancer in our clinic between September and December 2017. Preoperative color Doppler ultrasonographic (CDUS) measurements of renal intravascular parameters were obtained 24 hours before the operation. Similarly, postoperative CDUS measurements were performed 24 hours after RARP. Preoperative serum creatinine (Cr) level and eGFR were noted. On the postoperative first day, serum Cr levels were checked and eGFR was calculated.

The mean age of men was 61.9 years, and the mean operation time was 268.5 minutes. No significant differences between preoperative and postoperative intrarenal vascular parameters were observed (P > .05). Serum creatinine was significantly increased (P = .019), but eGFR did not change statistically significant after RARP (P = .144). While the change in the mean resistive index (ΔRI) was affected by intravenous (i.v.) infused fluid volume and renal width; the change in the mean pulsatility index (ΔPI) was only affected by renal width. Also, the change in the mean peak systolic velocity (ΔPSV) was related to age, i.v. infused fluid volume, and renal parenchymal thickness. Finally, the change in the mean end-diastolic velocity (ΔEDV) was related to age and renal width.

Renal functions and intrarenal vascular parameters return to baseline levels 24 hours after RARP.

Journal of laparoendoscopic & advanced surgical techniques. Part A. 2018 Sep 14 [Epub ahead of print]

Ekrem Islamoglu, Bulent Cekic, Ali Yildiz, Kamil Sarac, Kaan Karamik, Murat Savas

1 Department of Urology and University of Health Sciences , Antalya Training and Research Hospital, Antalya, Turkey ., 2 Department of Radiology, University of Health Sciences , Antalya Training and Research Hospital, Antalya, Turkey .