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Long-term renal function following zero ischemia partial nephrectomy

Authors Boga MS, Sönmez MG

Received 19 November 2018

Accepted for publication 27 January 2019

Published 4 March 2019 Volume 2019:11 Pages 43—52


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Jan Colli

Mehmet Salih Boga,1 Mehmet Giray Sönmez2

1Department of Urology, Antalya Training and Research Hospital, Antalya, Turkey; 2Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey

Abstract: Partial nephrectomy (PN), also known as nephron sparing surgery, is considered as the first-line treatment in small renal masses, especially in T1/2 tumors, and is applied as a standard treatment in advanced centers. The main expected outcomes from an ideal PN are surgical margin negativity, minimal impairment in renal function, and any surgical complications. Many authors have defined PN techniques as “zero ischemia partial nephrectomy”, where surgery is performed without clamping the main renal artery in order to protect the renal parenchyma from ischemic injury. Various PN techniques employed by surgeons include: selective or segmental renal artery clamping technique; off-clamp, clampless, or unclamped technique; preoperative superselective transarterial tumor embolization technique; sequential/ modified sequential preplaced suture renorrhaphy technique, radio frequency ablation-assisted technique, and combination of these techniques. The common goal of all these techniques is to provide zero ischemia without hilar clamping. This systematic review focuses on the long-term functional outcomes of PNs performed by zero ischemia techniques.

Keywords: zero ischemia, partial nephrectomy, renal function, complication, nephron sparing surgery, renal tumor

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