ORLANDO, FL (UroToday) - When should one clamp the renal hilum at partial nephrectomy?

Never -- according to investigators from Nara, Japan. Fujimoto and colleagues report a series of 162 patients (167 renal units) who underwent partial nephrectomy for tumors 4 cm or less. Tissue was resected using a microwave tissue coagulator (MCT). Median blood loss was 200cc (5-2,982). Five patients underwent nephrectomy for uncontrolled bleeding, prolonged urine leak, or "oncological" reasons. Overall cancer-specific outcomes were consistent with other series. No significant changes in renal function as judged by creatinine clearance were seen even in patients with imperative indications for surgery. These results are noteworthy, as the authors avoided renal ischemia in all cases.

Further investigation of MCT in renal surgery is warranted.

Presented by Kiyohide Fujimoto, MD, Nobumichi Tanaka, MD, Eijiro Okajima, MD, and Yoshihiko Hirao, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday Contributing Editor Alexander Kutikov, MD

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