Cold intravascular organ perfusion for XXXX during laparoscopic partial nephrectomy.

@entity1 @entity8 @entity63 @entity5 @entity190 @entity86 @entity715 @entity2332
PURPOSE: We report initial data on the safety and functional outcomes of @entity8 with arterial cold perfusion during partial nephrectomy. MATERIALS AND METHODS: From June 2007 to June 2009, 31 consecutive @entity1 underwent laparoscopic partial nephrectomy with @entity2332 using renal arterial perfusion with cold, lactated Ringer's solution during @entity8 . Doppler echography was done intraoperatively to evaluate renal perfusion. Complication data were reported prospectively. Median followup was 57 weeks (IQR 28, 83). RESULTS: The lowest recorded renal temperature during @entity63 was 14C. Median @entity5 size was 4.0 cm (IQR 2.7, 6.2). Median estimated @entity190 was 150 cc (IQR 100, 275). Median @entity63 time was 35 minutes (IQR 26, 41). Doppler echography identified intrarenal arterial blood flow postoperatively in all cases. The median change in the estimated glomerular filtration rate from preoperatively to postoperative day 2 was 4 ml per minute (IQR -29, 19). Two months postoperative in 20 @entity1 the median change was 3.5 ml per minute (IQR -6, 16.5). At last followup in 31 @entity1 the overall change in the estimated glomerular filtration rate was -0.5 ml per minute (IQR -6, 6). Six complications developed in a total of 5 @entity1 , of which 5 were grade 2 or less. One grade 3 @entity86 from an arteriovenous fistula at the @entity5 resection site was treated with angiography and selective embolization. CONCLUSIONS: Cold intravascular perfusion during laparoscopic partial nephrectomy can achieve @entity8 below 15C. It is not associated with an immediate risk of @entity8 or @entity715 , as measured by Doppler echography in this series. Early changes in postoperative estimates of renal function appear minimal.
