ORGAN PRESERVING SURGERY OF RENAL TUMOURS AT THE CONDITIONS OF HYPOTHERMIC PERFUSION IN SITU

Khareba G. G, Lesovoy V. N., Chshukin D. V., Poliakov N. N., Antonian I. M., Garagatiy A. I.  ORGAN PRESERVING SURGERY OF RENAL TUMOURS AT THE CONDITIONS OF HYPOTHERMIC PERFUSION IN SITU. ВІСНИК МОРСЬКОЇ МЕДИЦИНИ. 2020;1(86):41-52. ISSN 0049-6804.

DOI http://dx.doi.org/10.5281/zenodo.3773133

http://www.herald.com.ua

УДК 616. 61 - 006.6 - 089.87 - 036.65 – 08

DOI http://dx.doi.org/10.5281/zenodo.3773133

ORGAN PRESERVING SURGERY OF RENAL TUMOURS AT THE CONDITIONS OF HYPOTHERMIC PERFUSION IN SITU

Khareba G. G, Lesovoy V. N., Chshukin D. V., Poliakov N. N., Antonian I. M., Garagatiy A. I..

Kharkov National medical University;

Kharkov Regional centre for Urology and Nephrology named after V. I. Shapoval;

Kharkov Medical Academy of Post-Graduate Education;

e-mail: tornak@ukr.net.

Summary. The authors’ own experience of hypothermic renal perfusion usage at complicated organ preserving surgery of kidney tumours is described. 8 renal-cellular cancer patients have been examined. The only kidney had 3 patients; double-sided tumours had 3 persons; normal contra lateral kidneys had 2 patients. Tumours mean size was 5.8±1.5 cm. Surgery technique included separate appliance of clamps on renal vessels and follow-up examination of renal artery and vein lumen, artery’s cannulation and renal perfusion with custadiol liquid cooled to 4°C. Later on standard steps of renal resection were performed, arterial cannula was removed and the renal vessels incisions were sewed. Mean time of thermal ischemia was not more than 3.1±4.2 min. and mean term of cold ischemia – 39.3 ± 16.1 min. among intra-operative complications damages of renal intima predominated with its following thrombosis in 2(25%) observations. 2 from 8 patients had oligoanuria at post-operative period. After surgery mean level of creatinine was 142.6±26.1 mkmol/L (Δ mean + 22.9 mkmol/L), and the level of tubular filtration – 43.2±12.4 ml/mn (Δ mean – 8.6 ml/min). Hypothermic perfusion in situ is an effective method of renal protection, while it may be followed up by severe complications, in particular intima’s exfoliation .and bloody thrombosis of renal artery. May be further experience of this technique use and its improvement do this approach simpler and more safe in future.

Key words: nephron sparing surgery of kidney tumors, renal hypothermic perfusion in situ.