Objective: To examine the effect of warm and cold ischemia on functions of the
operated kidney in cases with a normal contralateral kidney undergoing nephron
sparing surgery.Methods: This study enrolled 40 patients with a normal contralateral kidney
and without a renal function threatening risk factor, who were operated with
NSS. The patients were randomized at admission. They were divided into 2 equal
groups as warm and cold ischemia. An ice application for 10 minutes was done to
cold ischemia group after clamping renal artery. Renal functions were evaluated
with Technesium-99m-Dimercaptosuccinic
Acid (DMSA) and serum creatinine at the preoperative and postoperative (day 1,
day 15, month 6, and month 12) period. Statistical analysis was done with Mann
Whitney U test, Wilcoxon Signed Rank test, and Fredman test. A p value below
0.05 was considered statistically significant.Results: There were no significant differences
between the groups in terms of age, body mass index, ischemia time, tumor size,
amount of hemorrhage, and procedure time. Both groups had a significantly
higher DMSA uptake at the preoperative period compared with the postoperative
period (postoperative day 1, day 15, month 6, and month 12) (p<0.001).
However, both groups had similar DMSA uptake results at the postoperative
period. Preoperative and postoperative creatinine levels were not significantly
different from each other in both groups.Conclusion: Based on tumor localization,
nephron sparing surgery without use of superficial cooling appears as a viable
option for small renal masses.
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