The Effect of Kidney Pedicle Clamping on Kidney Function after Partial Nephrectomy

Abstract

Introduction: Considering the controversial results in studies related to the clamping technique and the lack of pedal clamp and the information in this connection, the purpose of this study is to compare the two methods in the outcome of renal function. Materials and Methods: This is a descriptive-analytic study. The study population included 40 patients with partial nephrectomy. Patients were divided into two groups of 20. The first group was the patients who had their kidney pedicle during the clamping operation and in the second group; the operation was performed during the bleeding and without clamp pedicle. After classifying patients, routine tests and DTPA scans were performed on the day before surgery and questions were asked in the form of a checklist. The questions included demographic findings, anthropometric findings, duration of kidney cancer diagnosis, CT scan cancer rate, involvement of the patient, history of internal diseases and history of tuberculosis, and so on. The patients were then subjected to partial nephrectomy. After surgery, patients were asked for a daily test. After discharge in the third month, DTPA was also performed. All data entered the SPSS v18 statistical analysis program and analyzed data. Results: This study was performed on 40 patients (20 patients with pedicle clam and 20 patients without pedicle clam) with renal partial nephrectomy. The majority of patients were male. The mean age in pedicle clam group was 54.7 years and in the non-pedicle group it was 49.2 years. In this study, there was a case of urinary tract infection in the pedicle clam group, but no other complications were observed in the two groups (P = 0.311). Renal scan was performed after 2-3 months of renal surgeries. It was observed that the rate of renal failure in the pedicle clam group was significantly higher than that of the pedicle non-clamping group and this decrease was statistically significant (P = 0.000 ) The amount of bleeding during operation and the level of blood in the non-clamp group was more than the non-pedicle group, and this difference was statistically significant, but there was no significant difference between hemoglobin changes in the two groups during the first 24 hours. The mean duration of surgery in pedicle clam group was 139.25 and in the group without clamping was 149 minutes (P = 0.258). The average time of pedal clam was 20.65 ± 3.85m. Conclusion: The results of this study showed that the lack of kidney pedicle clam can improve kidney function in the short term, but increased the amount of bleeding in patients and the need for blood transfusion in patients.