The Studies Of Preoperative Vascular Evaluation And Postoperative Renal Function In Partial Nephrectomy

Objective: The control of preoperative blood vessels and the protection of post renal function have always been a hot topic in partial nephrectomy(PN).In this study we aimed to investigate the feasibility of the noncontrast-enhanced magnetic resonance angiography(NCE-MRA)to evaluate renal arteries in RCC patients before PN.And we tried to explore the effect and predictive value of various clinical factors on renal function after PN surgery.Methods: Retrospective analyzed 479 patients who underwent renal surgery between January 2013 and December 2015 in our department.Compared the renal artery reconstruction ability between the NCE-MRA and computed tomographic angiography(CTA).And measured the functional renal volume by using a 3D system,The clinical data of patients before and after operation were collected and the data of postoperative renal function were collected too,in order to explore the independent predictors for renal function by univariate and multivariate analysis.Results: The renal artery reconstruction performed by NCE-MRA is feasible and has a similar achievement compared with CTA.SD measurement system showed the average level of normal renal volume loss and functional renal volume preservation(FRVP)in different kinds of surgeries.The maximum tumor size,warm ischemia time(WIT)and FRVP were the independent factors in predicting acute kidney injury(AKI).The preoperative status of e GFR(pre-op e GFR),WIT and FRVP were the important independent factors in determining long-term functional recovery.Conclusion: The NCE-MRA is feasible with a lower side effect,and meets the requirements for making surgical decision.It has a broad application prospect in clinical practice.The WIT and FRVP were the important independent factors in determining renal function after surgery.Therefore,it is necessary to shorten WIT and protect normal renal parenchyma by using new techniques as much as possible in the operation.